Join the Twin Cities American Statistical Association Chapter

Membership Application Form

Twin Cities ASA Chapter dues are $10.00 per year for regular members and $3.00 per year for student members. 

You may pay chapter dues through ASA headquarters along with your society dues, OR you may pay them directly to

the chapter treasurer with the form below.

Note: National membership in ASA is not a prerequisite for membership and participation in chapter activities.

 

Please print and mail completed form with payment to (form available for download below):

Stan Lipovetsky, TC ASA Treasurer
GfK-Custom Research Inc
P.O. Box 27900
8401 Golden Valley Rd
Minneapolis, MN  55427-0900

 

NAME (first, middle initial, last) _________________________________________________

COMPANY OR SCHOOL_______________________________________________________

STUDENTS   Provide your department and advisor's name:

_________________________________________________________________________

MAILING ADDRESS __________________________________________________________

                               __________________________________________________________

                               __________________________________________________________

CITY_________________________________STATE _____________ ZIP ___________

PHONE (include area code) ________________________________________________

FAX (include area code)  ________________________________________________

National ASA Membership Number (if available)____________________________________

E-MAIL ___________________________________________________________________

WEB SITE: ________________________________________________________________

 

If you have any questions about membership or this form, please contact:

Stan Lipovetsky at 763-417-4509
stan.lipovetsky@gfk.com