AFCEA MEMBERSHIP APPLICATION
(Includes Signal Magazine)


    O NEW MEMBER       O RENEWAL (MEMBER #)  ______________

PLEASE PRINT            
O Mr.   O Dr.  O Ms.  O
Mrs.
_____________   ______________  _____________
Name (First)                        (M.Initial)                         (Last)

Branch of Service_______________  Mil Rank/Civil Service___________

Title  ______________________________________________________

Firm/Agency/org._____________________________________________

O Home     O Business Mailing Address ________________________

 __________________________________________________________

E-Mail Address  ______________________________________________

Daytime Telephone Number ____________________________________    
(Include country/City code or Area code)

Fax Number ________________________________________________
(Include country/City code or Area code)

Chapter Preference___________________________________________

METHOD OF PAYMENT
O  Check                             O Cash
 
LENGTH/Fee (US $  or equivalent)

   
  O 1 Year $35        (After January 1, 2003) 
   O 1 Year $15        (Full-Time Student) 
    O 3 Years  $85     (Save $20)       
    O Life  $400 (For members 40 or over 40 years of age)
    O  Life  $700 (For members under 40 years of age)

Submitted by        AFCEA TÜRKİYE     Chapter.
Eligibility Verified by _____________ Chapter Officer
Date:_________________

Mail With Your Payment to:

AFCEA TÜRKİYE
P.K. 101, 06172 Yenimahalle /ANKARA/TÜRKİYE
  Tel:  +90 (312) 592 15 74           Fax: + 90 (312) 354 13 02

Bank Account: AKBANK A.Ayrancı Branch
US
$ Acc.No: BU8/0023245/01-4
 YTL Acc. No: DHU/0024635/01-5

Note: Each section MUST be completed. AFCEA Membership is open to Citizens of Free World Countries. Citizen of ____________________________________

PRIMARY OCCUPATIONAL CLASSIFICATION
Which ONE below is your occupation? Show number ____
Then check all others that apply
O 20 Active Air Force
O 21 Active Army
O 22 Active Coast Guard
O 23 Active Marine Corps
O 24 Active Navy
O 25 Business/Industry
O 26 Consultant
O 27 MOD Civilian
         Gov. Employee
O 28 Educator/Academia
O 29 Full-Time Student
O 30 Non MOD Civilian   
         Government Employee
O 31 State/Local Government
         Employee
O 50 Other (Describe)

AREA OF INVOLVEMENT
Which One below best describes your work? Show number ____ 
Then check all others that apply
O 20 Data Processing
O 21 Engineering / R&D
O 22 Information Systems/IRM
O 23 Maintenance
O 24 Management
O 25 Operations
O 26 Procurement/Test &     
         Evaluation
O 27 Production
O 28 Sales/Marketing 
O 50 Other (Describe)

 APPLICATIONS
Which ONE below best describes your specialty? Show number ______ 
Then check all others that apply
O 20 Avionics
O 21 C3I
O 22 C4I
O 23 Command/Control
O 24 Communications
O 25 Computers
O 26 Computers in Communications
O 27 Electronic Warfare
O 28 Electronics
O 29 Emergency Management
O 30 Information Management
O 31 Intelligence
O 32 Law Enforcement
O 33 Public Safety
O 34 Radar
O 35 Satellites
O 36 System Management
O 50 Other (Describe)

Membership includes $20.00 for
your subscription to SIGNAL 
(AFCEA dues are tax-deductible 
as a business expense, but not 
as a charitable contrribution
)


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