Membership Oinlne Application
Personal:  個人資料
  First name ►    Last name►    中文姓名 ►   HELP
Sex ► Male Female      Date of Birth ►:  MM / DD / YYYY
Address►Country►
City/Town►State/Prov►Zipcode►
Type ► HELP   Phone# ► permanent email ►

Family:  (optional) 家庭資料
▼Relation ▼First name ▼Last name ▼中文姓名
   HELP
   HELP
   HELP

Education:  教育背景
▼Degree ▼School / Institute ▼Major / Expertise ▼Year

Field(s) of Specialty:   專長領域
 		Present Information:  現職資料
Job Title ►
Employer ►
Address ►
Email ►
Phone# ►

Preferred Contact Method:  聯繫方式  home work   or use method(s) provided below :
Email ►
Phone # ►
Cell # ►

Reference:  (optional) 介紹人 ►
 
  Membership Due:   (SELECT METHOD)  Regular member: $30, Associate member: $20, Student Member: $10.

pay by check
Please make a printout of the confirmation email (received after you submitted this form) along with a check payable to CASPAF, send via postal mail  to
Dr. William Chen,
3015 NW 23rd Terrace,
Gainesville, FL 32605

  pay online
          HELP


  payment process will start after
  the completion (submit) of this
  membership application.

Payment Reference number ►
please enter either the check number or Paypal Receipt Number (HELP) whichever is applicable.

  Complete and Submit :
Key in BOT Security text
from image shown at left

 
 		  
      

http://www.caspaf.org
 The Chinese American Scholars and Professionals Association of Florida, Orlando, FL 32816