NYCLSA Membership Form - July 1, 2023 - June 30, 2024
Please fill out the following information for NYCLSA membership. When completed and submitted, you will asked to click a link that will take you to the payment page. 
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Email *
First Name *
Last Name *
Pronouns *
Current Email Address

 *
Your Current Work Title/Position *
Your Department *
Your College/Institution *
Your College/Institution Address *
County where the College/Institution is located *
What Hub Are You Located In? Note: If you are unsure, please go here: http://www.nyclsa.org/hubs.html  *
Are you interested in helping with your Hub?  *
Work Phone Number *
Cell Phone Number *
Home Address *
Are you interested in serving on a NYCLSA Committee?  *
Are you interested in running for a Board position?  Details can be found here: http://www.nyclsa.org/board.html  *
Are you interested in serving as a peer reviewer for articles submitted to our scholarly journal FIRST (Forum for International Research on Students and Teaching) *
Please indicate Membership Type  *
Is The Membership Part of an Institutional Membership (One Free Membership after Four Paid Membership As Long As All Memberships Are Within The Same Department)? *
The next page will bring you to payment. Please write the name of the person on the credit card that will be used for payment below (this will help us match form and payment if the card name is different than the person getting membership).  *
Please Click the 'Submit' button below for payment. If you have the option to write a "note" (only some will) please write NYCLSA 23-24 and the name of the person who is getting the membership. For example, "NYCLSA 23-24 Samantha Trumble". 
A copy of your responses will be emailed to the address you provided.
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