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Sigma Xi Affiliate Circle Enrollment Form


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Select Your Sigma Xi Affiliate Category


  Professional  (US $70):   Professional  (US $56): Individuals who work or have earned a degree in science or engineering, or non-scientists who support the mission of Sigma Xi.

  Student  (US $35):   Student  (US $28): Students with interests in science, technology, engineering or math.

Promo Code:  

Personal & Contact Information

Prefix:
First Name:
Middle Name:
Last Name:
Suffix:
Email Address:
Daytime Phone:
Date of Birth (mm/dd/yyyy):
Gender:
Ethnicity:
Mailing Address

Home      Business

Address Line 1:
Address Line 2:
Address Line 3:
City:
State/Province:
Zip/Postal Code:
Country:

Education & Professional Information

Degree You Are Seeking:  
Expected Graduation Date:     Month:    Year:
School Information:
  Name of School:
  City:
  State:
Highest Degree Attained:    
Company/Institution:
Job Title:

Areas of Scientific Interest (Please indicate all that apply):

Science      Technology      Engineering      Math

Sigma Xi Affiliate Professional Dues:


US $70.00


Sigma Xi Affiliate Student Dues:


US $35.00


Sigma Xi Affiliate Professional Dues:


US $56.00


Sigma Xi Affiliate Student Dues:


US $28.00

Your Sigma Xi Affiliate membership dues include one year of American Scientist magazine. Please indicate which format of American Scientist magazine you'd prefer to receive:
                     Print Version          Digital Version
  

Optional:


US $ 7.49
Add a copy of The Rightful Place of Science: Citizen Science for $4.99 plus $2.50 shipping and handling. This is 30% off the list price.
Purchase includes membership in SciStarter.


  

Total Payment Amount:

US $35.49

US $28.00

US $42.49

US $35.00

US $63.49

US $56.00

US $77.49

US $70.00

Chapter Affiliation

You have the option to affiliate with a Sigma Xi chapter, or you can select 'Membership At
Large' if you do not wish to affiliate with a specific chapter. Click here to see chapter locations.

Select Your Chapter Affiliation:


Privacy Policy


I agree to receive mailings from all organizations that Sigma Xi feels may be of interest.

I only want to recieve mailings from Sigma Xi.

Please do not use my address for marketing. I understand that I will still receive mailings related to my Affiliate Circle Membership.


Payment

Credit/Debit Card Type:
       Visa          MasterCard        American Express        Discover

Card Number:
Exp Month:       Exp Year:
3 or 4 Digit Security Code:
Name on Card:
Billing Zip Code:

Please verify your information before submitting this form.


         


Sigma Xi, The Scientific Research Honor Society
P.O. Box 13982
Research Triangle Park, NC 27709
Telephone: 800-243-6534 or 919-549-4691
Fax: 919-595-8114
E-mail: membership@sigmaxi.org
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