Local Membership Application
(To join AITP national online, go to www.aitp.org/Join)

Member Information

Name (First -- Middle Initial -- Last): 

Gender:  Female     Male

Date of Birth: 

ASU Address 

Street: 
City: 
Zip Code: 



Permanent Address 

Street: 
City: 
State: 
Zip Code: 




Phone: () -

eMail Address: 

Classification:  First year     Sophomore     Junior     Senior     Grad student

What Is Your Major? 

Check All That Apply: 

  I am a full-time student (12 credit-hours or more)
  I have a job (hours worked per work )

Payment Included  

Local dues only ($5.00):    Paid Online    Cash    Check
Both local and national dues ($30.00):    Paid Online    Cash    Check