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Welding Journal | April 2015

Join or Renew: Mail: Form with your payment, to AWS Call: Membership Department at (800) 443-9353, ext. 480 CONTACT INFORMATION AWS MEMBERSHIP APPLICATION q New Member q Renewal q Mr. q Ms. q Mrs. q Dr. Please print • Duplicate this page as needed Last Name:_______________________________________________________________________________ First Name:___________________________________________________________________ M.I:_______ Birthdate: _____________________________ E-Mail:____________________________________________ Cell Phone ( )__________________________ Secondary Phone ( )______________________ Were you ever an AWS Member? q YES q NO If “YES,” give year________ and Member #:____________________ Company (if applicable):___________________________________________________________________ Address:________________________________________________________________________________ _______________________________________________________________________________________ City:_____________________________________State/Province:__________________________________ Zip/PostalCode:_____________________Country:______________________________________________ Œ Who pays your dues?: q Company q Self-paid  Sex: q Male q Female Ž Education level: q High school diploma q Associate’s q Bachelor’s q Master’s q Doctoral q Check here if you learned of the Society through an AWS Member? 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Option available only to students in U.S., Canada & Mexico. STUDENT MEMBERSHIP TOTAL PAYMENT......................................................................................$_____________ PAYMENT INFORMATION Payment can be made (in U.S. dollars) by check or money order (international or foreign), payable to the American Welding Society, or by charge card. q Check q Money Order q AMEX q Diners Club q MasterCard q Visa q Discover q Other CC#:____________ / ____________ / ____________ / ____________ Expiration Date (mm/yy) ________ / ________ Signature of Applicant:_________________________________________ Application Date:_______________________ OFFICE USE ONLY Check #:_______________________________ Account #____________________________________ Source Code: IT Date:_________________________________ Amount:_____________________________________ REV. 11/14 Fax: Completed form to (305) 443-5647 Online: www.aws.org/membership 8669 NW 36 St, # 130 Miami, FL 33166-6672 Telephone (800) 443-9353 FAX (305) 443-5647 Visit our website: www.aws.org


Welding Journal | April 2015
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