SAS Membership Application

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Name

First

Last

Gender

How you were born, not how you feel...

Birthdate

Occupation

Employer or School Name

Contact Email

Contact Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Membership Type

Additional Club Member(s)

Gender

Birthdate

Interests and Hobbies

Reasons for Joining the SAS

Referred By (if applicable)

First

Last

Preferred Communication

applicable) Interests Applicant

Agreement

I have read and agree to the SAS terms and conditions, rules and code of conduct. I understand that failure to follow club rules may result in termination from the SAS.

Signature

Clear Signature

Date of Application