D4 (Class of 2020) ASDA Application for 2019-2020

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D4 (Class of 2020) ASDA Application for 2019-2020

Please fill out the information below.

Total Amount: $100
[Dues breakdown: $88 to National ASDA, $12 to our LECOM ASDA Chapter!]

*VENMO (@asdalecom) is the accepted form of payment.

If you have any questions, please contact asdalecom@gmail.com.

NOTE: You can join at any time but in order to maximize your membership we suggest you join ASAP!

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First Name *

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Last Name *

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Gender *

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Phone Number (XXX)XXX-XXXX *

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LECOM Email Address *

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