/ MEMBERSHIP APPLICATION

CANADIAN AERONAUTICS AND SPACE INSTITUTE

and constituent societies
104 - 350 Terry Fox Drive, Kanata, Ontario K2K 2W5 CANADA
Tel. (613) 591-8787 Fax (613) 591-7291 E-mail:

New Member

/

Renewal: CASI Member #

Amounts shown are calculated using 13% HST (ON, NB, NL)
The tax added to the membership fee is based on your province –HST 12% (BC), 13% (ON, NB, NL), 15% (NS), GST 5% (AB, QC, SK, PE, MB, YK, NT)

A) Check The Grade For Which You Are Applying

Junior Member / Persons engaged in full time studies at a College or University.

Fee $35.00 + $4.55 HST= $39.55

Associate Member / Persons who are interested in joining CASI but are not eligible to join as a Member, Junior Member or Senior Member. Fee $90.00 + $11.70 HST= $101.70
Member / Persons who have achieved recognized standing in aeronautics, astronautics or associated technologies through employment (6 years) and education (degree). Fee $90.00 + 11.70 HST= $101.70
Senior Member / Persons age 65 and over, or 55 and over AND fully retired. Fee $60.00 + $7.80 HST= $67.80
B) Personal Data
Dr. / Prof. / Mr. / Mrs. / Ms. / Other: / Gender: M F / Birth date (mm/dd/yyyy) / //
First Name / Middle Initial / Last Name
Mailing Address
Address / City
Prov./State / Postal/Zip / Country
Telephone / () - / Fax / () - / Cell / Pager / () -

Professional Information

Organization / Job Title
Address / City
Prov./State / Postal/Zip / Country
Telephone / () - ext: / Fax / () - / Toll Free / 1---
Contact Information
Email / URL / Contact By / Letter Email Fax
C) Billing Preference(Please ensure your spam filter allows our attachments.)
I wish to receive membership invoices electronically. / I wish to receive events invoices electronically.
D) Societies/Sections (Please indicate the primary society or section you wish to be affiliated with.)
1. Aerodynamics(AERO)
2. Aerospace Manufacturing(AM)
3. Aerospace Structures & Materials (AS&M) / 3. Aircraft Design & Development (AD&D)
4. Astronautics(ASTRO)
5. Canadian Air Cushion TechnologiesSociety(CACTS) / 6. Canadian Navigation Society (CNS)
7. Flight Mechanics & Operations (FM&O)
8. Propulsion (PROP)
E) Journals Members receive access to both e-journals. Please indicate the one that is of most interest to you.
Canadian Aeronautics & Space Journal / Canadian Journal of Remote Sensing
F) How did you hear about us? (Please select only one)
CASI Clipper
CASI Log
Work for Corporate Partner / CASJ
CJRS
Promotional material / Friend/colleague
Internet Search
Other: / Attended a conference
Which one?

… /2

G) Personal Interests (Please select three in the order of your interest and enter the corresponding number)
 / P1 /  / P2 /  / P3
1. Aerodynamics
2. Air Cushion Technology
3. Aircraft Design & Development
4. Aircraft Maintenance, Repair &
Overhaul
5. Aircraft Modification & Upgrade
6. Astronautics
7. Aviation & Space Law
8. Aviation & Space Medicine / 9. Avionics
10. Communication Systems
11. Computer Systems
12. Defence Electronics
13. Flight Operations
14. Flight Testing
15. Life Sciences
16. Materials
17. Navigation, Guidance & Control / 18. Production Engineering
19. Propulsion Systems
20. Quality Management
21. Remote Sensing
22. Robotics
23. Simulation
24. Space Flight
25. Space Infrastructure
26. Space Manufacturing / 27. Space Science
28. Space Systems
29. Space Technologies
30. Spacecraft Design &
Development
31. Structures
32. Systems Integration, Test
33. Training & Education
34. Unmanned Aerial Vehicles
H) Work (Please select only one)
Administration
Analysis
Certification
Consulting
Customer Support / Design
Development
Flight Operations
Maintenance
Management / Marketing
Procurement
Production
Quality Assurance
Research / Retired
Student
Teaching
Testing
Other :
I) Education (All applicants)
Diplomas, Certificates, Degrees / Colleges, Universities / Year Completed
1.
2.
3.
J) References Two persons familiar with the work or academic qualifications of the applicant. (Not required for Junior Members.)
Name / Address / Telephone
1. / () -
2. / () -
//
Applicant's Signature / Date (mm/dd/yyyy)
K) Membership Fees /

Fee

/ Payment
Annual Dues For Grade / as per section A / $
CASI Log / CASI Clipper / Included in Dues / -
Journals (Section E) / Included in Dues / -

Sub total

/ $
CDN ResidentsTax(R106842149)
HST12% (BC), 13% (ON, NB, NL), 15% (NS),
GST 5% (AB, QC, SK, PE, MB, YK, NT) / $

Payment due with application*

/ $
Visa / MasterCard / American Express / Cheque / Money Order
Card Number / Expiry Date
Card Security Code
Card Holder (please print clearly) / Signature

*Applications received without payment or incomplete applications will not be processed.

**Payment to be made in Canadian dollars.

January 2008