Online Membership Application Form

In case of technical difficulties with this registration page email the webmaster.
For all other questions go to the SESHA Web Site.




 Contact Data
*First Name
*Last Name
*Job Title
*Company/Institution
*Address 1
Address 2
*City
*State/Province
*ZIP/Postal Code
Country
*Phone
*Email

 *Membership (Expires 2018-12-31): (Select Appropriate Category)
Associate Membership
Student Membership


 Chapter Membership
Please select your chapter(s) below:

Chapters
New England
Rocky Mountain
Texas Hill Country
Arizona
Pacific Northwest
N. California
N Texas
NY Capital Region
Twin Cities
Murray State


 Demographics
Employment Demographics: (choose one)


Job Function Demographics: (choose one)


Employment Level Demographics: (choose one)



 Mailing List
SESHA does occasionally make its snail mailing list available for a one-time rental. Rental of the mailing list is approved ONLY for items relevant to our profession. SESHA does not allow names and address information to be retained by the renter. If you do not wish to have your name included in the rental, please check the following box:

Please remove my name from the rental list

Captcha


Check all fields carefully and use the button below to see a summary of your entry.