Online Membership Form for Latin America
In case of technical difficulties with this registration page
email the webmaster
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For all other questions go to the
ASP Web Site
.
Obligatory fields
are marked with
*
Contact Data
Name Prefix
*
First Name
Middle Name
*
Last Name
Name Suffix
Job Title
Company/Institution
*
Address 1
Address 2
Address 3
*
City
State/Province
*
ZIP/Postal Code
*
Country
Click to select
Antigua and Barbuda
Argentina
Aruba
Bahamas, The
Barbados
Belize
Bolivia
Brazil
Chile
Colombia
Costa Rica
Cuba
Curaçao
Dominica
Dominican Republic
Ecuador
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Nicaragua
Panama
Paraguay
Peru
Puerto Rico
Suriname
Trinidad and Tobago
Uruguay
Venezuela
*
Email
Alternative Email
FAX
Home Phone
Work Phone
Cell Phone
Homepage URL, http://
Referred by
I do NOT want to appear in the online member directory. (Note that access to the directory is for ASP members only)
*
Membership FEES
for Latin America: (Select Appropriate Category)
Full Member - online only - Expires 12/31/2024
US$ 72
Associate Member - Jrnl online only - Expires 12/31/2024
US$ 27
Emeritus Member - Jrnl online only - Expires 12/31/2024
US$ 20
Retired Member - Jrnl online only - Expires 12/31/2024
US$ 35
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Hard Copy Journal (per year) - 2024
US$ 40
Check all fields carefully and use the button below to see a summary of your entry and total fees.
