Mail Checks To:
ASIDIC
P.O. Box 3212
Maple Glen, PA
19002-8212

Phone and Fax:
(215)-654-9129
E-Mail:
info@asidic.org

ASIDIC Associate Membership Dues Invoice

Available for persons who are not employed by an organization with more than two employees. Associate Members are not eligible to vote at ASIDIC meetings. Annual dues are $125.

* Indicates required field

*Organization:
*Address:
*City:
State:
ZIP or Postal Code:
*Country:
*Representative's Name:
*Representative's Title:
*Representative's Phone:
Representative's Fax:
*Representative's Email:
Website URL:
will be listed on the Membership page of the ASIDIC Web siteAlternate Rep. Name:
Alternate Rep. Title:
Alternate Rep. Phone:
Alternate Rep. Fax:
Alternate Rep. Email:

*Payment Options

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