Academy Membership Form

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We welcome your interest and involvement. If you would like to join or renew your membership in the Academy, please fill out this form and complete payment on the next page.

Important: You must click submit at the bottom of this page and follow the prompts to submit your payment on the next page for your membership to be recorded.

Questions about membership? Contact us at academy@analyticarts.org

Name *

Please indicate your academic discipline(s) and degree(s): *

Is there a particular area of interest or type of involvement you would like to contribute to the Academy?

Please provide any other information about yourself and your professional work that you would like to be included on our website:

Are you a member of Division 39? *

Yes

Contact Information

Please provide the information requested below and indicate what, if any, of your contact information you want to appear on our website directory (www.AcademyAnalyticArts.org).

Email *

Address *

Personal Phone

Office Phone

Website

Contact Information *

Publish on Website Directory

Do Not Publish

Name

Address

Personal Phone

Office Phone

Website

Membership type *

Please select the membership category below that represents your desired membership status and amount.

Member ($50)

Student Member ($20)

Corresponding Member ($25)

Supporting Member ($100)

Submit

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