ANS-SR Membership Registration Question Title * 1. Tell us about yourself! Name Address City State -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Personal Email (Preferred due to firewall blockage) Phone Number Question Title * 2. Where do you work? (Please indicate if you are retired.) Company City State Work Email (if personal email not provided) Question Title * 3. Are you an ANS National member? Yes No (If yes, please enter your ANS number.) Question Title * 4. Why are you interested in joining the ANS-SR section? Networking Community outreach Social and technical meetings Continuing education Other (please specify) Question Title * 5. Are you interested in volunteering? If so, what are your interests? Section functions support Executive committee Community outreach Other (please specify) Question Title * 6. Which local section committee or executive committee position are you interested in supporting? Chair Vice-chair Secretary Treasurer Membership Chair Publication Chair Arrangement Chair Public Outreach Chair Programs Chair CNTA liaison Retiree liaison Young members liaison Other (please specify) Done