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MEMBERSHIP APPLICATION/RENEWAL

This on-line form is an application for or renewal of ASTD-LA membership.

On the following confirmation of submission page, there is a link to make your membership payment on-line via Cvent.

If you prefer to send a check, print this form, fill it in and mail it with your check to ASTD-LA, 9852 W. Katella Ave. #187 Anaheim, CA 92804.

For questions, please call Denise Ross or send her an email at astdla@aol.com.

 
First name
Middle initial
Last name
Title
Company
Address 1
Address 2
Address 3
City
State
Zip Code (digits only) -
Phone
Fax
E-mail
Web site
Keywords/description
(here you can put more information related to your experience, certifications, etc. This information is optional and will be used by the online membership directory)
Referred by
Are you interested in volunteering/committee involvement?

ASTD - LA occasionally sells its mailing list to qualified providers of professional products and services.
Check here if you prefer to have your name removed from this list:

Professional status

(You can select more than one
status by using CTRL+click)
Internal External Academic
Industry
Content area in which you work
(Use CTRL+click to select more than one)
Company size
Ethnic identification (optional)
Education
Gender
Years in field  

NEW MEMBER DUES

RENEWAL DUES
INDIVIDUAL $125.00 INDIVIDUAL $85.00
CORPORATE $90.00 per employee
(minimum of 4 employees per organization) 		CORPORATE $70.00 per employee
(minimum of 4 employees per organization)
STUDENT $50.00 Full Time Student Not Working Full Time STUDENT $50.00 Full Time Student Not Working Full Time
REINSTATEMENT $85.00

Payment information

You will receive a follow-up email within 1 to 5 business days and after your membership application/renewal has been processed and payment has been confirmed. A member package will then be mailed to you.

Please review your information, then click on the Submit button below.

  Please contact ASTD-LA by calling (562) 908-3020 or by e-mail at astdla@aol.com  
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