ALSAME Membership Registration & Renewal Form

ALSAME membership dues allow members to vote and to be placed on a mailing list or an electronic list-serve to receive meeting announcements and other important information. Membership dues must be submitted by May 1st each year. For instance, 2021-22 payment of dues provides membership for one year (May 1, 2021 - May 1, 2022). The cut off for membership dues is December 1, 2021. Any insitutional member that registers after that cut off will need to renew in May of 2022.

Please note that alsame is a nonprofit organization led by a volunteer Executive Board. Membership dues allow Alsame to meet monthly and most importantly, help Alsame raise scholarship funds for Latinx students.

With your contribution, we will continue to advocate and serve Latinx students all across Michigan.

Name *

First Name Last Name

Company/Institution/Organization/Individual *

Title or Position *

Home or Company Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number (best number to reach you) *

Please enter a valid phone number.

E-mail *

example@example.com

ALSAME Membership Form Payment Information:

Please choose your membership level: *

Student Membership

$ 20.00 one-time payment

Individual/Personal Membership Often for retired community members or for individuals that do not intend to represent an organization or institution in any way.

$ 50.00 one-time payment

Community Membership Up to 3 members can be a part of this membership and this option is for community non-profit organizations only.

$ 125.00 one-time payment

Institutional Membership This membership account is for up to 5 members of a post secondary education institution or for a larger private company.

$ 225.00 one-time payment

Will Mail a Check This option is for individuals that wish to pay using a check. Please mail your check to Alsame at: 401 Hall St SW, Suite 385, Grand Rapids, MI 49503. Make check payable to ALSAME.

Free one-time payment

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

ALSAME MEMBERSHIP REGISTRATION OR RENEWAL FORM