Membership Application Form – CASTNC

Online Reservation for On-site Passport Service

旅美科技协会北卡分会会员申请

Chinese Association for Science and Technology – NC Chapter

(CAST-NC)

Membeship Application Form

Name:

First Name

Last Name
中文姓名（Chinese Name）:
Company/School:
Job Title:
Email:
Work Phone:

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(###)

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Home Phone:

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(###)

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Home address:

Street address
,
city

state

zip Code
Highest Education Received:

Degree

Major

Year Obtained
List Your Technical and Professional Specialties:

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Please Select Membership Type:

Individual Membership ($20/year)
Family Membership ($30/year for two adults in a family)
(Please enter the second member information including name and email address in the comment field below.)
Student Membership ($10/year)
Life-Time Permanent Membership ($200)
Comment:

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