High Energy Astrophysics Division

AFFILIATE MEMBERSHIP APPLICATION

PREFERRED NAME AND ADDRESS

First Name *

Middle Initial

Last Name *

Affiliation / Institution *

DIRECTORY ADDRESS

Enter your WORK address here. It will be listed in the online and/or print AAS Membership Directories only after you opt-in.

Street Address

Address Line 2

City

State/Province

Zip/Postal Code

Country

Phone Number

Primary Email Address *

HOME ADDRESS

Enter your HOME address here. This will be used to determine your congressional district if in the USA.

Street Address

Address Line 2

City

State/Province

Zip/Postal Code

Country

Home Phone or Cell Number

Alternate Email Address

Preferred Mailing Address 🛈

Directory Address

Home Address

Preferred Billing Address 🛈

Directory Address

Home Address

08/19

1667 K Street NW, Suite 800, Washington, DC 20006 | 202-328-2010 | Fax 202-588-1351 | membership@aas.org | https://aas.org