Please complete the membership application below. Print a hard copy and mail with your check, payable to AzASCD.   Membership Type: Annual Dues $25               Student Dues $10 Title: Dr.      Mr.       Ms.      Mrs. Last Name First Name          Initial Title/Position Organization  Preferred Mailing Address: Home     Work Address 1   Address 2    City    State           Zip Code Phone # (work)   Phone # (home)   Email                                         Thank you for joining AzASCD. Please print a copy of this completed form and mail it with your check (payable to AzASCD) to Vic Mondino 26222 N 72nd Avenue Peoria, AZ 85383