If you would like to apply for membership into the Arizona Physiological Society, please fill out and submit the form below.

Membership

Choose the membership category for which you are applying.

Name

First Name

Last Name

Email address

Date of birth

YYYY

Gender

Most advanced degree obtained

Current position or degree program

Please list your current position.

Or, If you are enrolled as a degree-seeking student, please provide the following information: Anticipated graduation date, Degree being sought, Institution, Major field, Advisor.

Current institution

Department

Institutional address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone (primary)

(###)

###

####

Phone (secondary)

(###)

###

####

References/referrals

Members of the American Physiological Society (APS) are automatically approved for membership in the AzPS. If you are not currently a member of the APS, list below two references who are members of the APS/AzPS (note: if you do not know any members of the APS, email the Executive Committee via Christos Katsanos at Christos.Katsanos@asu.edu for an application referral).

Payment To complete payment and be considered for membership, you will need to register for the annual meeting. Please do so after submitting this form.

Terms of membership review

Upon receipt of this form, provisional membership is granted and participation in the upcoming meeting allowed. Executive Committee Members will review that you qualify for membership in accordance with the By-Laws of The Arizona Physiological Society. Full membership will be decided by the end of the AZPS annual meeting.

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