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ASPSH Student Membership Form
First Name:
*
Last Name:
*
Name of School:
*
Student ID Number:
*
Address:
*
City:
*
Province:
*
Postal Code:
*
Phone Number:
E-mail:
*
What type of membership is this?:
New Membership
Membership Renewal
Other Comments:
How would you like to pay for your membership ($15 for 12 months):
*
Cheque
PayPal
Note: Payment options will be completed on the next page, after you click Submit.