Application for GAI Student Membership
Basic Information
Prefix
First Name*
Middle Name
Last Name*
Suffix
Primary Contact Information
Street Address*
Street Address Cont.
City*
State/Province*
Zip*
Country
Phone*
Email Address*
College or University
School Name:
Degree Pursuing: Associate Bachelors Masters Doctorate
Other
Graduation
(month/year)
Major/Minor:
Membership fees
Standard Annual Membership Fees for 2015
Description EURS
Student and apprentices Membership 50.00€

I represent and warrant to GAI that the registration information I have submitted is truthful, accurate, complete and up to date, including my full legal name and educational background.

Signature (required): Date:

Your digital signature indicates that you agree to be bound by this provision.