Membership Application

	First Name*

	Last Name*

	Address Line 1*

	Address Line 2

	City*

	State*

	Zip Code*

	Email Address*

	Male/Female

	Phone Number*

How did you first hear of the Alliance for International Education?

	Present Employer (+ internet address)

	I accept, honor and will promote the AIE's Statement of Purpose from this date on. *

Please Note: Questions marked with an asterisk (*) are required.