Nevada Society of Association Executives

Membership Application

Please print the form below and mail the completed form along with your check for the amount of your membership to NSAE, 5250 Blue Gum Court, Las Vegas NV 89148 or if paying by credit card fax the completed application to Maury Astley at 702-254-4263. For your convenience you may type your information in the fields below.

Select Your Membership Classification

Other - If you are in another dues category please fill in your dues amount here: $

Contact & Payment Information

Name:
Title:
Organization:
Phone:
Business Address:
City:
State:
Zip:
Email:
Website:
Credit Card Type	Mastercard Visa American Express
Credit Card Number
CV #
Expiration Month	Year
Expiration Year
Billing Name
Billing Address

Questions? Please contact:

Maury Astley, CAE, Executive Director
NSAE, 5250 Blue Gum Court, Las Vegas, NV 89148
Email: maury@cox.net Telephone: 702-254-4263
Cell Phone: 702-271-0233 Web: www.nsae.net

Members Information Change
Let us know if there has been a change in address or staff at your organization so our records are current.

Annual Dues
If you sign up as an Association or Allied member, you will receive reduced dues for your additional staff.