2012 SALIS Membership Application Use this form to pay online with a credit card, using secure PayPal. (to pay with a check or postal order, go here instead)
-- STEP 1: FILL OUT APPLICATION FORM ONLINE.
This is a: New membership Renewing membership
If your contact information has not changed, check the box and type in your name & email (and credit card holder's name & email if different). You don't have to fill out the whole form, but be sure to review & update your options for SIGS and Committees below.
Important! If the credit card holder is not the member, enter the credit card holder's name & email in the spaces below the member. Note: American Express Corporate Cards are not accepted by PayPal. Use a different card, or pay with check or postal order using the print form (see above).
Section I - Contact Information for Member
Member Name
Section II - Membership Options
Type of membership: Full (with Addict Prof) - NorthAmer: $100 USD Full (with Addict Prof) - outside NorthAmer: $135 USD Full (no Addict Prof): $100 USD Elisad in Europe (with Addict Prof): $95 USD Elisad in Europe (no Addict Prof) $60 USD Retired or unemployed (with Addict Prof) - NorthAmer: $50 USD Retired or unemployed (with Addict Prof) - outside NorthAmer: $85 USD Retired or unemployed (no Addict Prof): $50 USD Student (with Addict Prof) - NorthAmer: $50 USD Student (with Addict Prof) - outside NorthAmer: $85 USD Student (no Addict Prof): $50 USD Affiliate (with Addict Prof) - NorthAmer: $50 USD Affiliate (with Addict Prof) - outside NorthAmer: $85 USD Affiliate (no Addict Prof): $50 USD (indicate preference re: optional Addiction Professional print subscription)
Check if you are interested in the following Special Interest Groups or Committees: [Read all about it!] Special Interest Groups Canadian SIG Multi-Cultural SIG RADAR Network SIG South East Asian SIG
Committees Advocacy Development Information Technology International Networking Membership & Outreach Full members only: check if you'd like to receive hard copies or electronic notications about: NIAAA Publications NIDA Publications ONDCP / NCJRS Publications SAMHSA Publications
