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  MIRESEVINI TEK AKADEMIA SHQIPTARE-AMERICANE E SHKENCAVE  
Fill the application online and send by email
Print the form and send by mail

AAAS Membership form

Annual Contributing Membership form
(please complete this form on BLOCK CAPITALS)

Name:

Address:

City: State: Zip Code

Phone Number:

E-mail Address:

MEMBERSHIP STATUS (click on the appropriate checkbox):

New Member ( Registration contribution: $100)
Renewal ( Contribution renewal : $75 )

CONTRIBUTING STATUS (click on the appropriate checkbox):

Special sponsor membership contribution: up to $250 (giving free access to the online publications) 
Lifetime contribution: $1250

ATTENTION => FOR PRIVATE COMPANIES

Annual contribution : $250

SURVEY:

(1.) Are there any comments and other activities you would like to see the AAAS:

(2.) Your profesion!

INSTRUCTIONS:

(1.) Use your keyboard to type information in the text boxes.

(2.) Use your mouse to left-click on the appropriate checkbox.

(3..) Print or email your completed membership form, together with the photocopy of your diploma (transcript of grades please) and 2 photografies. Then make a payment of your choice to AAAS.

(4.) Mail the form and check to: AAAS, 2128, 72 Street, Brooklyn, NY, 11204. Phone: (718) 234 4427

Contributions payment on our bank account:

Academy Account#: 0396018491, SOVEREIGN BANK, from abroad: SWIFT:(SVRNUS33). SOVEREIGN BANK 1.877.SOV.BANK www.sovereignbank.com
0000386978
Leke
Albania
Raiffeisen Bank
0001386978
Euro
0002386978
Dollar
OUR BANK ACCOUNT ARE:
Kosovo
Raiffeisen Bank
1505001003574439
Euro
SWIFT code
RBKORS22
Macedonia
OHRIDSKA BANK
530500015762360
Dinar
 
"PRIVACY AND DATA PROTECTION: We take the privacy of personal data to our member very seriously. The AAAS will only use any personal data connected in accordance with current USA and Albanian data protection legislation".

Name:

Signature:

Date:

 

  
 

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