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Name:
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Add to ListServ?	Check this box if you wish to be added to our ListServ..
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Membership Division:	Member Fellow Associate Student
Membership Dues Licensed Member $225 Second Year Licensed Member $200 First Year Licensed Member $175 Full time Academic Member $135 Non-Licensed Member $165 Associate Member $165 Student $30  Exempt $10  Vendor Associate $200
By checking this box I certify that I meet the “exempt member” requirements and thus my dues are complementary. Please select - New Application or Renewal?      New Membership Application Membership Renewal