Membership Application
Complete the membership application form below or download a .pdf version and mail it to ESSAE Headquarters. Fields indicated with an asterisk (*) are required for form submission.

Referred by:
Name*:
Title/Position:
Organization:
Address*:
City/State/Zip*:
Telephone*:
Fax:
Email:
Web:
Membership Category*
	Primary Active Member: $170 (association executives only) For staff engaged in the management of associations. Dues for the first staff member from an association.
	Second Active Member: $105 (association executives only) For additional staff members from an association with a Primary Active Member.
	Subsequent Active Member: $55 (association executives only) For additional staff members from an association with Primary Active and Second Active
	Associate Member: $240 (Supplier/Vendor) For individuals who represent a fi rm or corporation off ering products or services to associations.
	Additional Associate Member: $130 (Supplier/Vendor) For additional staff representatives of fi rms or corporations off ering products or services to
	Affiliate Member: $105 (government officials, students, educators) For those individuals not covered by Active or Associate Membership, with a special interest in association management, or individuals who spend less than 50% of their working time on association activities.
Payment*
	I will mail a check for the full dues amount to ESSAE Headquarters at: 991 Broadway, Suite 208, Albany, NY 12204.
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