|
| Member ID (if available): |
|
|
|
| Full Name (English): |
|
|
| Full Name (Korean): |
|
|
| Address: |
|
|
| Phone Number(Home or Mobile): |
|
|
|
| College or University: |
|
|
| Degree or Year: |
|
|
| Major: |
|
|
| School Address: |
|
|
|
| Current Affiliation: |
|
|
| Employed since: |
|
|
| Department and/or Area of Work: |
|
|
| Title: |
|
|
|
| KSEA Experience: |
|
|
| |
|
(For example, chapter president)
|
| Specialties (up to 3): |
|
|
| |
|
(For example, organic chemistry, electronic materials & adhesives)
|
| KSEA Local Chapter: |
|
|
| |
|
(Chapters can be found on the KSEA web, http://www.ksea.org - organization)
|
| Professional Affiliation: |
|
|
| |
|
(Korean-American Associations only. For example, KASBP, KOCSEA)
|
|
Member Status and Annual Fee: |
|
Regular, $35
Graduate, $15
Undergraduate, free
|
| |
|
(payable to “KSEA”. A group such as a local chapter and a professional affiliation can submit the membership fees together)
|
| |
|
Address: Junho Cha 1344 Bellevue way NE #2 Bellevue, WA
|
|