Application: Student Membership to Scientific Organization

In order to promote participation in professional societies, the ACS WI Local Section will subsidize student/early graduate memberships in professional scientific organizations. The grants will reimburse 50% of membership fees for awardees. All current undergraduate, graduate, and postdoc members of the ACS and ACS WI Local Section are eligible for this offer. If you would like apply to have your ACS membership fees subsidized, first join the ACS as a Basic Level member, and then apply for this grant to upgrade your membership. You must provide a membership payment receipt in your email to the ACS WI Local Section Treasurer.

Name *

First

Last

Email *

Mailing Address *

ex) 123 University St. Madison, WI 53706

ACS Member Number *

This grant is only available to American Chemical Society – Wisconsin Local Section members. Students can either join the ACS and choose Wisconsin as their Local Section when they join or join the ACS and then become Affiliate Members to the ACS WI Local Section (annual membership $2).. Your ACS Member Number is a 7 or 8 digit number – see this page for more information.

Current Employer or University Name *

ex) UW-Platteville

Current Position *

Undergraduate student
Graduate student
Post doc
Other

Scientific Advisor

If you are working with a specific faculty member or other advisor, add their name here.

Scientific Organization You Wish to Join *

ex) ACS; NOBCChE; American Society for Mass Spectrometry

What level of membership do you want to purchase?

Some organizations offer different membership levels or options. Describe which option you chose.

Annual Membership Dues *

ex) $250

URL Address of the Scientific Organization's Membership Page *

ex) https://www.acs.org/content/acs/en/membership.html

In 250 words or less, state your reasons for joining the this organization and how it will help you in your professional career: *