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IV. Sponsor’s Name
(if applicable) Member ID #
V. Method of Payment
Total Amount Enclosed:
o Check enclosed (make check payable to AGA)
AGA Membership Application
2208 Mount Vernon AvenueAlexandria, VA 22301
800.AGA.7211703.684.6931
I. Membership Data/DuesPlease choose a membership category and fill in the appropriate dues from the list on the back of this application. By joining, you allow AGA to contact you via email regarding member-related activities.
o Full Government—$100/year—This class of membership is available to individuals currently working in government, academia and not-for-profit organizations.
o Private Sector—$160/year —This class of membership is available to sole proprietors and those working for private companies, corporations or partnerships.
o Early Career—$45/year—This class of membership is available to individuals with fewer than three years of professional experience who work in private or public sector.
o Student (full-time)—$30/year—This class of membership is available to full-time college/university students who are not gainfully employed.
Primary Chapter Dues
Additional Chapter Membership(s) Optional Dues
(please refer to list on the reverse side)
II. Name & Home Address
o Mr. o Mrs. o Ms. o Dr. o Prof. | o male o female
Preferred Address: o Home o Business
Name FIRST MIDDLE LAST
Home Address Apt/Suite#
City State/Province ZIP Code Country
Home Phone Home Email
III. Business Information
Job Title Dept.
Organization
Business Address Apt/Suite#
City State/Province ZIP Code Country
Business Phone Business Email
Employer: o Federal o State o County o City o Nonprofit o Private o Academia o Student
Responsibility Area: o Academia o Accounting o Administration o Auditing o Budgeting o Consulting o Financial Management o Grants Management o Information Systems o Investigation o Legal o Management/Admin. o Other o Performance Mgt. o Program Mgt.
How did you hear about AGA? o AGA Chapter o AGA Conference o AGA Email o AGA Publication o CGFM Program o Direct Mail o Employer o Friend/Co-Worker o Internet o Non AGA Conference
Age: o < 21 o 21 – 25 o 26 – 30 o 31 – 35 o 36 – 40 o 41 – 45 o 46 – 50 o 51 – 55 o 56 – 60 o 61 – 65 o 66+
Highest degree attained: o Associate o Bachelor’s o Law/Judicial o Master’s o Doctorate
Certifications:
Charge to my: o VISA o MasterCard o American Express o Discover
Card Number Expiration Date
Signature
Printed Name
F = Full Government Member P = Private Sector Member E = Early Career Member S = Student Member
CHAPTER F/P E S
ALABAMAMontgomery 10.00 10.00 5.00Northern Alabama 10.00 10.00 10.00
ARIZONAPhoenix 5.00 5.00 3.00Southern Arizona 10.00 10.00 10.00
ARKANSASCentral Arkansas 10.00 10.00 10.00
CALIFORNIACentral Coast 5.00 5.00 5.00Inland Empire of CA 10.00 10.00 10.00Los Angeles 5.00 5.00 5.00Los Angeles Civic Center
5.00 5.00 5.00
Silicon Valley 5.00 5.00 5.00Sacramento 5.00 5.00 5.00San Diego 7.50 7.50 7.50San Francisco 6.00 6.00 6.00
COLORADODenver 5.00 5.00 5.00
CONNECTICUTHartford -0- -0- -0-
DELAWAREDover Capital 10.00 10.00 5.00
DISTRICT OF COLUMBIAWashington, DC 10.00 5.00 5.00
FLORIDANaples Paradise 10.00 10.00 10.00Southeastern Florida -0- -0- -0-Tallahassee 5.00 5.00 5.00
GEORGIAAtlanta
Coastal Georgia 10.00 10.00 10.00
5.00 5.00 5.00
GUAMGuam 5.00 5.00 5.00
HAWAIIHawaii 5.00 5.00 -0-
IDAHOIdaho Centennial -0- -0- -0-
ILLINOISChicago 7.00 7.00 7.00Springfield 7.50 7.50 7.50
INDIANACentral Indiana1 10.00 10.00 10.00Circle City 5.00 5.00 5.00Indianapolis2 5.00 5.00 5.00
Annual Chapter Dues Table
CHAPTER F/P E S
IOWADes Moines 5.00 5.00 5.00
JAPANJapan 5.00 5.00 5.00
KANSASTopeka -0- -0- -0-
KENTUCKYCentral Kentucky 5.00 5.00 5.00
LOUISIANABaton Rouge 5.00 5.00 5.00New Orleans 10.00 10.00 10.00
MAINEAroostook County 20.00 20.00 20.00Maine 10.00 5.00 5.00
MARYLANDBaltimore 5.00 5.00 5.00Montgomery/ Prince Georges
10.00 6.00 -0-
MASSACHUSETTSBoston 7.50 7.50 7.50
MEXICOMexico City -0- -0- -0-
MICHIGANDetroit 5.00 5.00 5.00Greater Lansing 7.50 5.00 5.00West Michigan 7.50 5.00 5.00
MINNESOTAMinneapolis/St. Paul -0- -0- -0-
MISSISSIPPIGulf Coast -0- -0- -0- Jackson 5.00 5.00 5.00West Central Mississippi
5.00 5.00 5.00
MISSOURIKansas City -0- -0- -0-Mid-Missouri -0- -0- -0-St. Louis -0- -0- -0-The Ozarks 5.00 5.00 5.00
MONTANAMissouri River -0 -0- -0-
NEBRASKALincoln -0- -0- -0-Omaha Metro Area 10.00 10.00 10.00
NEVADANorthern Nevada -0- -0- -0-
NEW JERSEYNorthern New Jersey 7.50 -0- -0-Trenton 5.00 5.00 2.00
CHAPTER F/P E S
NEW MEXICOAlbuquerque 10.00 10.00 10.00New Mexico 10.00 10.00 10.00
NEW YORKNew York City 5.00 5.00 5.00New York Capital -0- -0- -0-Rome -0- -0- -0-
NORTH CAROLINANorth Carolina Triangle
7.50 7.50 7.50
NORTHERN MARIANA ISLANDSNorthern Mariana Islands
-0- -0- -0-
OHIOCincinnati 5.00 5.00 5.00Cleveland 5.00 5.00 5.00Central Ohio1 5.00 5.00 5.00Greater Columbus2 -0- -0- -0-
OKLAHOMAOklahoma City 7.50 7.50 5.00
OREGONMid-Willamette Valley -0- -0- -0-Portland 5.00 5.00 5.00
PENNSYLVANIACentral Pennsylvania 5.00 5.00 5.00Philadelphia 10.00 10.00 -0-
PUERTO RICOPuerto Rico -0- -0- -0-
SOUTH CAROLINACharleston 10.00 10.00 10.00
SOUTH DAKOTASouth Dakota 10.00 10.00 10.00
TENNESSEEChattanooga 10.00 10.00 -0-East Tennessee 7.50 7.50 7.50Nashville 5.00 5.00 5.00
TEXASAustin 5.00 5.00 5.00Dallas 5.00 5.00 2.50El Paso -0- -0- -0-Houston 5.00 5.00 5.00San Antonio 15.00 15.00 15.00
UTAHNorthern Utah 5.00 5.00 5.00
VIRGINIANorthern Virginia 10.00 10.00 10.00Richmond 5.00 5.00 5.00Roanoke 5.00 5.00 5.00Shenandoah Valley 10.00 -0- -0-Virginia Peninsula -0- -0- -0-
CHAPTER F/P E S
WASHINGTONCentral Washington 5.00 5.00 5.00Northwest Inland Empire
-0- -0- -0-
Olympia 10.00 10.00 10.00Seattle 5.00 5.00 1.25
WEST VIRGINIACharleston 10.00 5.00 5.00Mid-Ohio Valley 5.00 5.00 5.00
WISCONSINSouthern Wisconsin -0- -0- -0-
STUDENT AFFILIATE CHAPTEROld Dominion University
N/A N/A -0-
Indiana University N/A N/A -0-1State and Local Focus 2Federal Focus
Please call AGA’s Customer Satisfaction Center at 800.AGA.7211 if you do not see a chapter listed in your area.
*Dues subject to change without notice.
Updated August 2015
