New
Mexico Network for Women in Science and Engineering
PO Box 51926, Albuquerque, NM 87181
NMNWSE_Board-L@list.unm.edu
https://archive.nmnwse.org
Membership Form
Membership year October 1 through September 30 (or fall elections, whichever is later)
Print, fill in, and mail completed form and your dues to NMNWSE at the address at top.
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This form is for: |
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Membership Renewal |
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$40 Professional |
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Information Change |
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$10 Student / Teacher / Retired / Non-employed |
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New Membership |
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$ Donation* for ____general fund ____student awards |
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____EYH scholarships@$10/student ____EYH (gen) |
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Contact Information: |
*Donations to NMNWSE are tax deductible to the full extent of the law. Membership
fees are not. If you need a receipt for tax purposes, please check here:______ | ||
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evening: |
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cell: |
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Preferred Newsletter option: |
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mail: |
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Education:
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Deg: |
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School: |
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School: |
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Indicate your interests. Please mark area to appear in the membership directory by 'MD', additional interests by 'X'.
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Anthropology |
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Chemistry |
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Geology |
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Medical Sciences |
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Astronomy |
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Computers |
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Health Sciences |
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Physics |
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Biology |
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Education |
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Management |
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Psychology |
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Business |
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Engineering |
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Mathematics |
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other (specify): |
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Indicate the local chapter with which you wish to be affiliated:
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Central (Albuquerque Area) |
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Northern (Los Alamos and Santa Fe Area) |
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Eastern (Portales Area) |
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Southern (Las Cruces and Silver City Area) |
NMNWSE Membership Preferences (optional)
Indicate NMNWSE outreach and activities that interest you:
Outreach - Expanding Your Horizons (EYH), Student Awards, etc:
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EYH All |
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EYH Silver City |
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EYH Los Alamos |
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EYH Las Cruces |
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EYH Santa Fe |
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EYH Carlsbad |
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EYH Albuquerque |
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new EYH in |
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Science Fair/Student Awards |
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judging awards |
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National Girls Collaborative Project |
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Improving NMNWSE Careers book |
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updating related links on website |
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Other outreach (specify): |
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Annual and Local Meetings:
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Annual Meeting attendance |
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Annual Meeting planning |
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Annual Technical Presentations |
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Local Meetings with networking |
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Local Meetings with talks |
Board Activities (BA):
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BA Website |
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BA Fundraising |
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BA Publicity |
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BA Newsletter |
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BA Archives |
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BA at-large |
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BA Membership |
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BA IMPACT! award |
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BA local board |
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BA other (specify): |
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Indicate the listserver(s) you'd like to be on: (members automatically added to NMNWSE-L)
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NMNWSE_Board (board members automatically added) |
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LAWIS (Northern Chapter) |
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Central Chapter (Central Chapter Activies) |
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Central_EYH (EYH Albuquerque) |
Email(s) to add to list server(s):
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home |
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work |
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other (specify): |
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If you have alternate emails you'd like to be able to post from,
but do not want subscribed, please list them below
(otherwise posts from non-subscribed emails bounce to the webmaster for approval, a spam control measure):
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Internal Use |
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Action |
Date |
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dues received |
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database change rec'd |
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database changed |
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sent to local president |
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Membership Year |
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Last Paid |
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What would you like to get back from NMNWSE membership?
Other Comments?