2018/19 Dues Form

Member Number:*
Name (as listed with Headquarters):*
Address:
Skills/Areas of Expertise:
E-mail Address:*
Preferred number (calling post):*
-
Alternate Phone Type:
Alternate Phone:
-
Age Classification:*
Are you transferring into this chapter?:*
Previous Chapter:*
Previous Chapter President:*
Previous Chapter President Email:*
Organization/Place of Employment:
Occupation (or Former Occupation, if retired):

Payment Calculation

Mandatory Fee:*
Membership type (when last active):
Category Change Fee*
Recent Graduate?:
National Dues:*
Local:*
Are you being reclaimed?: (inactive in 2017/18)*
Reinstatement Fee: *Note - Life Members do not pay a reinstatement fee*
DELTA RESEARCH & ED. FOUNDATION (DREF):
 $ 
PROFESSOR ENDOWED CHAIR:
 $ 
PRESERVE OUR LEGACY INITIATIVE:
 $ 
INTERNATIONAL SUSTAINABILITY INITIATIVE:
 $ 
Estimated Total: