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WYASFAA Membership Application

Red = Required Field

Your Name:
Your Title:
Institution:
Address:
City:
State:
ZIP:
Phone:
Your Email:
Voting Member?	Yes \| No
Annual Due:	$50
Membership dues are assessed per institution. You may have as many members from your institution join WyASFAA but only the designated voting member is allowed to vote. Please be sure each person from your institution, that wants to be a WyASFAA Member, completes this form. Non-voting members are a huge part of WyASFAA and they play a big part in the success of WyASFAA. Please send your dues to: Adrianne Plemel Western Wyoming Community College 2500 College Drive PO Box 428 Rock Springs, WY 82902 Phone 307-382-1634 Fax 307-382-1631 aplemel@wwcc.wy.edu Questions about your membership contact Kelly Svenkesen KSvenkes@lccc.wy.edu

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