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Dues Category *	NOGLSTP Membership ($40.00 for one year) $40 Sliding Scale Annual NOGLSTP Membership Dues NOGLSTP Membership ($35.00 for one year) $35 Sliding Scale Annual NOGLSTP Membership Dues NOGLSTP Membership ($30.00 for one year) $30 Sliding Scale Annual NOGLSTP Membership Dues NOGLSTP Membership ($25.00 for one year) $25 Sliding Scale Annual NOGLSTP Membership Dues NOGLSTP Post-Doc Membership ($20.00 for one year) $20 Annual NOGLSTP Membership Dues for Post-Docs NOGLSTP/NPA Membership ($45.00 for one year) $45 Annual NOGLSTP membership dues bundled with annual National Postdoctoral Association dues. Regularly $20 for NOGLSTP and $35 for NPA. NOGLSTP Student Membership ($10.00 for one year) $10 Annual NOGLSTP dues for undergraduates, graduate students, unemployed, and low-income retirees Trial Newsletter (Free for 4 months) Sign up for 1 trial newsletter. This will also give you access to see our OutList for the next 4 months.
Payment Method *	PayPal secure credit card payment Offline Payment Pay by check or money order
Your Name * Your First & Last name
Your E-Mail Address * A confirmation email will be sent to you at this address
Choose a Login Name (User ID) * It must be 4 or more characters in length and may only contain small letters, numbers, and the underscore '_'
Choose a Password * Must be 4 or more characters
Confirm your password * Enter password again
Additional Name Add your domestic partner or spouse to your membership profile.
Mailing Address * 1st line of your mailing address
Mailing address additional line use if needed
Mailing address additional line use if needed
City *
State or Province *
Postal Code * Zip code for US addresses, Mail Code for non-US addresses
Country * if not USA, type in country name
Phone use format xxx-xxx-xxxx
Privacy Options * Would you like to be listed on the NOGLSTP OutList or the NOGLSTP Membership Roster? OutList is visible to all registered NOGLSTP community. Membership roster is available to dues-paying NOGLSTP members only. No mailing addresses will be listed for either. Only current dues-paying members will be listed. We will never share your contact information without your permission.	List me on the OutList and on the NOGLSTP membership roster List me on the NOGLSTP membership roster but not on the OutList Do not list me on the OutList or on the NOGLSTP membership roster
NOGLSTP Bulletin * Do you prefer to receive your quarterly newsletter in print via postal service or electronically via email?	Send me a print newsletter through postal service Email my newsletter
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Latest Degree Earned * Choose one. We tried to think of all the possibilities, but if you have to choose OTHER, you can include your latest degree with your degree subject.
Subject Subject in which latest degree was earned.
Specialty or Technointerest
Professional affiliations Professional societies/organizations you belong to.
URL URL or personal web page. ...http://
NOGLSTP Affiliates Are you a member of a NOGLSTP caucus, regional group, or affiliate? Check all that apply.	LGBT Chemists and Allies (American Chemical Society) Los Angeles Gay and Lesbian Scientists Mathematics Assn of America or American Mathematical Soc OSTEM Out in Science Technology Engineering and Math National Postdoctoral Association NOGLSTP - Chesapeake Region NOGLSTP at Indiana University/Bloomington NOGLSTP at Purdue NOGLSTP at Oregon State University San Diego QuEST
Volunteer Interests Check all that you are interested in helping us with.	Serve on Board of Directors Serve as Chair or Secretary Help at AAAS events Organize or host local event Write newsletter articles Edit the newsletter Speak about/on behalf of NOGLSTP at an event Serve on recognition awards commitee Assist with the mentoring program Write a grant proposal Evaluate scholarship applications Help with fundraising Start/represent a GLBT caucus at my professional society Don't know but would like to help with something Nothing at this time
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