Membership Form

AFASO Membership Form

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Membership Type: *

Membership Type: NEW MEMBERSHIP RENEWAL
Membership Tier: *

Membership Tier: INDIVIDUAL ASSOCIATION AFFILIATE CORPORATE
SECTION 1

MEMBER CONTACT INFORMATION
*Star the e-mail and phone number you would like listed in the directory
TITLE *

TITLE Mr. Mrs. Miss Ms.
Full Name Full Name * First Middle Last
HOME ADDRESS HOME ADDRESS *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
MAIN TELEPHONE
WORK TELEPHONE (if
different)
HOME TELEPHONE
MOBILE PHONE
PRIMARY EMAIL *
SECONDARY EMAIL
SECTION 2

MEMBER INFORMATION
Member: *

Member: Yes No
Would you like to receive ASAFU membership information? *

Would you like to receive ASAFU membership information? Yes No
If yes please list here.
Do you want to subscribe to the AFASU newsletter? *

Do you want to subscribe to the AFASU newsletter? Yes No
Please indicate if you would be willing to serve on a chapter committee: *

Please indicate if you would be willing to serve on a chapter committee: Yes Not at this time
Is there a specific committee or an industry you would like to serve on?
(Committees are listed at https://www.afroasianunion.org/sectors)
Permission to use photographic images:

Photographs of AFASU members will be used in various AFASU communications incl. the newsletter, publications
and website for other members. Group photographs that are taken at AFASU events and conferences will be used
without identifying individual members.
For individual photographs, please indicate your permission for use:

For individual photographs, please indicate your permission for use: AFASU has my permission to use and identify photographs of me. AFASU does not have permission to use and identify photographs of me. AFASU must contact me before using any identified photographs of me in AFASU communications.

Membership Form

Membership Form

Photo

SECTION 1

SECTION 2

Permission to use photographic images: