American Society of Criminology

1314 Kinnear Road, Columbus, OH 43212-1156 Phone: (614) 292-9207 Fax: (614) 292-6767

Website: www.asc41.com E-mail:

MEMBERSHIP FORM FOR 2017 DUES (JANUARY 1 – DECEMBER 31)

Please fill in your information below, and return this form (via fax or mail) and your check or money order (in U.S. Funds), or with your credit card information (Master Card, Visa, Discover and American Express accepted). Dues include subscriptions to the journals, Criminology: An Interdisciplinary Journal and Criminology and Public Policy; and the newsletter, The Criminologist.

****Dues must be received/postmarked by April 1, 2017 to be eligible to vote in the election. (Students are not eligible.)****

ASC MEMBER DUES (REQUIRED) Please choose ONE:
□ Active – Tier 1 ($95)
(Salary $75,000/yr or less) / □ Student – Online Only($55)
(All publications – online only) / □ Retired ($60)
□ Active – Tier 2 ($115)
(Salary $75,001-$125,000/yr) / □ Student – Print ($95)
(See print options below.)
□ Active – Tier 3 ($135)
(Salary $125,001/yr or more)
CONTACT INFORMATION (REQUIRED)
Name:
First / Middle / Last / Maiden
(if a past ASC member using that name)
Institution/Affiliation:
(informational purposes only, not address field)
Email Address:
Phone Number:
Mailing Address1:
Mailing Address2:
Mailing Address3:
City, State, Postal Code:
Country:
ATTENTION ALL INTERNATIONAL MAILING ADDRESSES: The American Society of Criminology (ASC) is NOT responsible for any taxes or customs fees that you may incur when receiving mail from ASC. Generally, these may occur when receiving large packages. Specifically, ASC sends out packages to late joiners or renewers who need to be caught up on the hard copies of the journals.
Check the appropriate options below: (We will default these to Yes if you do not select anything.)
Include me in all emails sent from ASC to members □Yes □ No
(This will not exclude emails pertaining directly to your membership, such as dues renewal notices and receipts.)
Include me in the public Membership Directory □Yes □ No
(You can fill in your Directory Details on page 2 of this form.)

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Member Name:
YOU ARE NOT REQUIRED TO FILL ANYTHING OUT ON THIS PAGE BUT PLEASE READ CAREFULLY SO YOU DO NOT ACCIDENTALLY OPT IN OR OUT OF ANYTHING INCORRECTLY.
PUBLICATIONS (This does NOT apply to any ASC Division publications.)
Check the appropriate options below:
□ All memberships include online access to the journals. Please check the box (if desired) to receive hard copies (at no additional cost) of Criminology and Criminology & Public Policy as well. (Not applicable for Student-Online only membership.)
□ All memberships include online access to the newsletter. Please check the box (if desired) to receive hard copies (at no additional cost) of The Criminologist as well. (Not applicable for Student-Online only membership.)
MAILING LISTS NAME REMOVAL
□ The ASC provides membership’s mailing addresses to interested external entities. Check here if you would like to have your name removed from the membership list that is used for this purpose.
AGE (CIRCLE ONE)
18-30 / 31-40 / 41-50 / 51-60 / Over 60
GENDER (PLEASE SPECIFY)
RACE (CIRCLE ALL THAT APPLY)
African American/Black American/Black / Native American/American Indian/Alaskan Native
Asian/Asian American / White
Hispanic/Latino(a) / Other – Please specify:
PRIMARY FIELD OF EMPLOYMENT (CIRCLE ONE)
Faculty/Student/Emeritus / NGO
Government Research Agency / Private Research Center
Government Service Agency / Other
ONLINE MEMBER DIRECTORY INFORMATION
The directory is public. Only fill in what you want to appear on the website.
E-Mail Address: / Phone: / Fax:
Areas of Expertise: (Please limit to three areas.)
Organization/Affiliation/Institution:
Facebook Account: / Twitter Account:
LinkedIn Account:

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Member Name:
DIVISIONS (OPTIONAL) Division Dues must be concurrent with ASC dues.
Biopsychosocial Criminology
□ Active/Retired Member ($15) / □ Student Member ($5)
Communities and Place
□ Active/Retired Member ($20) / □ Student Member ($5)
□ One-Time Inaugural Donation $______(Optional)
Corrections & Sentencing
□ Active/Retired Member ($25) / □ Student Member ($10)
□ Active/Retired Member w/ Handbook ($50) / □ Student Member w/ Handbook ($35)
Critical Criminology & Social Justice
□ Active Member ($25) / □ Student Member ($5)
Developmental/Life-Course Criminology * Includes online journal access
□ Active/Retired Member ($10)*
□ Active/Retired Member w/print journal ($30)* / □ Student Member ($5)*
Experimental Criminology
□ Active/Retired Member ($20) / □ Student Member ($5)
International Criminology
□ Active/Retired Member ($30) / □ Student Member ($15)
People of Color & Crime
□ Active/Retired Member ($30) / □ Sustaining Member - 1 Year ($100)
□ Supporting Member - 1 Year ($60) / □ Student Member ($5)
Policing
□ Active/Retired Member ($15) / □ Student Member ($5)
Terrorism & Bias Crime
□ Active/Retired Member ($15) / □ Student Member ($10)
Victimology
□ Active/Retired Member ($20) / □ Student Member ($5)
White Collar & Corporate Crime
□ Active/Retired Member ($20) / □ Student Member ($5)
Women & Crime * Includes online journal access
□ Active/Retired Member ($25)* / □ Student Member ($5)*
□ Active/Retired Member - Special Circumstances ($5)*
RUTH D. PETERSON FELLOWSHIP FOR RACIAL AND ETHNIC DIVERSITY (OPTIONAL)
The ASC provides academic fellowships to minority graduate students. Donations can be made along with membership dues. Please note the amount of your contribution. $______
PAYMENT INFORMATION Checks/Money Orders should be made payable to American Society of Criminology (U.S. Funds only). A service charge will be assessed for all returned checks.
Payment Total: / $ / □ Check/Money Order / □ Visa / □ Master Card / □ American Express / □ Discover
Credit Card #: / Exp. Date: / CCV#:
Billing Street Address: / Billing Zip Code:
Name on Credit Card:
Email Address for credit card receipt (if different from above):

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