NEW-TO-NAFSA 50% SAVINGS MEMBERSHIP APPLICATION 2015-2016
Join NAFSA today and receive all NAFSA benefits at a special introductory rate of only $220—a savings of
50% off the regular rate. This offer is only available to individuals who have never been members of NAFSA
or whose previous membership expired on or before July 1, 2012. Offer good until February 15, 2016.
Questions? Call 1.202.495.2500 or email [email protected].
1 Membership Category
Please check ONE
o REGULAR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $440 $220
Employed by:
o Academic Institution
o International Education Organization
o Other:____________________________________________
o ASSOCIATE*. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
o Community Volunteer
o Full-Time Student
o Retired
o U.S. Dept. of State-Sponsored Rep. [of overseas
educational advising center]
MEMBERSHIP TERM ENDS JUNE 30, 2016
Please type or clearly print your information below.
$147
*Verification of status required. Student ID, letter from previous employer or
community group/organization must accompany application.
2 Scope of responsibility:
Check ONE that best describes your position
o President, Chancellor, Rector, Principal, Executive Director, or CEO
o Provost, Chief Academic Officer, or COO
o Chief International Officer
o Academic Dean
o Faculty
o Student Services or Administrative Dean or Vice President
o Lead two or more departments or divisions
o Lead one department or division
o Professional
o Support to professional(s), department(s), or division(s)
o Consultant
o Service provider
o Community volunteer
o Retiree
o Student
3 I primarily work:
Check ONE that best describes where you work
o In the U.S.
o Outside the U.S.
4My work supports individuals and/or groups:
Check ONE that best describes your work
o Traveling to the U.S. only
o Traveling from the U.S. only
o Traveling both to and from the U.S. only
o Traveling to and from countries including the U.S.
o Traveling to and from countries other than the U.S.
o Through other activities in international education and exchange
5 Main areas of responsibility:
Check ALL that apply
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Fax (credit card payments only) or mail completed form
with appropriate payment to: NAFSA Membership Department, PO Box 79159, Baltimore, MD 21279-0159 n Fax 1.202.737.3657
o Institutional exchange agreements
o Admissions/credentials evaluation/placement
o Community programs
o English language program administration
o Federal or state relations
o Immigration/regulatory practice
o Intercultural teaching
o Internationalizing curriculum
o Lead internationalization strategy
o Lead the institution/organization
o Lead academic program
o Marketing
o Program and/or service development
o Provide professional services (health and safety, insurance, legal)
o Research and scholarship
o Scholar advising
o Student advising
o Student recruitment/retention
o Teaching and instruction
o Other:______________________________________________
NAME
TITLE/OFFICE
INSTITUTION/AGENCY/ORGANIZATION
MAILING ADDRESS
MAILING ADDRESS
CITY STATE/PROVINCE ZIP/POSTAL CODE COUNTRY
TELEPHONE/FAX
E-MAIL
Dues Payment:
Dues are billed annually in July. Please return application with the appropriate
payment. Purchase orders are not accepted.
Membership Dues $____________________
Airmail Fee: $70* $____________________
$20.00
Initial Processing Fee $____________________
TOTAL $____________________
*Charged to members based outside the U.S., Mexico, or Canada without APO/AFO address
Method of Payment
o Check enclosed payable to NAFSA. Check #____________
(Checks must be in U.S. dollars drawn on a U.S. bank)
o MasterCard
CARD ACCOUNT #
o Visa
o American Express
EXPIRATION DATE
PRINTED CARDHOLDER NAME
SIGNATURE
NAFSA makes its mailing list available to commercial organizations and professional
associations whose products and services may be of interest to NAFSA members.
Please check below if you do not wish to receive any of these or other mailings.
Please don’t send (check all that apply):
o Commercial mailings
o Commercial e-mail promotions
o NAFSA.news (NAFSA’s weekly e-newsletter)
NAFSA invites the membership of individuals who do not practice discrimination on the
basis of race, religion, political persuasion, national origin, immigration status, ethnicity,
disability, gender, age, marital status, sexual identity, or sexual orientation. Application for
membership signifies acceptance of NAFSA’s Statement of Ethical Principles. The Statement of Ethical Principles may be viewed at www.nafsa.org/ethics.
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