CACS Membership Registration Form

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Please make the membership fee payment by PayPal/Zelle/Venmo/ Check/Cash (Sorry, no credit cards!). Please enter your name in the Memo section during the transaction. Thank you!

PayPal link: https://www.paypal.com/paypalme/cacshq
Zelle account name: "cacshq.org@gmail.com"
Venmo link: https://account.venmo.com/u/cacshq
Check payable to “Chinese American Chemical Society”

If you have any questions, please contact us through email at "info@cacshq.org".

Email *

I hereby apply for membership to the CACS as a: *

Regular Member ($20/year)

Student ($10/year)

Life Member ($150 in one payment)

Please choose one of the following Payment Methods. If you choose PayPal/Zelle/Venmo, please leave your name in the notes. *

PayPal

Zelle

Venmo

Check

Cash

Other:

Last Name: *

First Name *

Organization: *

Local Chapter Membership (Select one and you will be automatically enrolled) *

East Chapter - covers New Jersey, New York, Connecticut, Pennsylvania and Delaware

Great Lakes Chapter - covers Illinois, Indiana, Iowa, Minnesota, Michigan, Ohio and Wisconsin

South-West Chapter - covers Texas (main), Arizona, California, Colorado, Nevada, New Mexico, Utah and Wyoming

Northern California Chapter - Greater San Francisco Bay Area

National Student Committee

None of above

Required

Field/Specialty: (Optional)

Highest Degree Earned: (Optional)

Phone #: (Optional)

Your Chinese name here (optional)

Notes & Comments (if any)

A copy of your responses will be emailed to the address you provided.

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