Physics Society Membership Application

Full Name

First NameLast Name

Email Address

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Phone Number

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Mailing Address

Street Address

Street Address Line 2

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Academic Institution or Affiliation

Current Status

Select Membership Type

Areas of Interest in Physics (select all that apply)

Briefly describe your motivation for joining the Physics Society

Would you like to volunteer or participate in Physics Society events or committees?

How did you hear about the Physics Society?