AFCEA Individual Membership Application

*First Name
*Last Name
*Email Address
*Address 1
Address 2
*Organization Type
*Year of Birth
 (Format: YYYY)

* Magazine Delivery Method

Print Digital Both Print and Digital
*Membership Type
1-Year Membership ($75)
3-Year Membership ($180)
1-Year E1-E6/Gov/Civil Equivalent ($20)
Life Membership ($1500)
Academic Membership ($15)
MilGov Individual Membership 1 Year ($50)
MilGov Individual Membership 3 Year ($120)
*Name on Card
*Card Number
*Card Expiration
/ (MM/YY)
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