Twin Cities
Chapter
of ASA

Last Updated:
August 16, 2006
by Qi Li

Join the Twin Cities American Statistical Association Chapter
Membership Application Form

Twin Cities ASA Chapter dues are $5.00 per year for regular members and $2.00 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:

Stan Lipovetsky, TC ASA Treasurer
GfK-Custom Research Inc
P.O. Box 27900
8401 Golden Valley Rd
Minneapolis, MN55427-0900

NAME (first, middle initial, last) _______________________________________

ORGANIZATION _____________________________________________________________

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 763-542-0800
lipovetsky@Gfkcustomresearch.com