Association of Egyptian-American Scholars, Inc. http://www.aeascholars.org Founded in the United States and Canada in 1974
Membership Form 266 Junction Rd., #29, Madison – WI 53717 Name:_______________________________________________________________________________ Last First Middle
Mailing Address: _______________________________________________________________________ Street Address
________________________________________________________________________ City State Zip Code Phone: ______________________________________________________________________________ Work Home Mobile E-Mail Address: _____________________________________________
Undergraduate Education: _____________________________________________________________________________________ School Field Degree Year Graduate Education: ____________________________________________________________________________________ School Field Degree Year
_____________________________________________________________________________________ School Field Degree Year
Employer: ____________________________________ Position/Title: _________________________ Annual Dues:
NOTE and
Lifetime membership ($500) Sponsor member ($100) Active member ($50)
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Associate-nonvoting ($35) Student-nonvoting ($10)
Annual Dues, Donations,
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Conferences expenses are Tax Deductible in US and Canada
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Associate-nonvoting (Inside Egypt) (LE 50) -----Voluntary donation Total Payment (enclosed)
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$________
Signature: ______________________________ Date: ________________________
Please make checks payable to the Association of Egyptian-American Scholars and mail it along with application to the AEAS Treasurer: (Dr. Mohamed Hegab, 3 Utah, Irvine, CA 92606
