Full Name

Email Address

Phone Number

Current Membership Status: Current Membership Status: Member Non-Member

Briefly explain why you are interested in becoming a CoAND member:

Have you previously been a CoAND member? Have you previously been a CoAND member? Yes No

If yes, please provide the membership period:

Are you currently facing financial constraints that make it challenging for you to afford the annual membership fee? Are you currently facing financial constraints that make it challenging for you to afford the annual membership fee? Yes No

Please describe your involvement or interest in the field related to the organization's focus.

How would being a CoAND member benefit your professional development or contribute to your career goals?

Are you involved in any community initiatives, research, or projects that align with the mission of the CoAND?

Would you be willing to contribute or volunteer your time and expertise to the CoAND community in any capacity? Would you be willing to contribute or volunteer your time and expertise to the CoAND community in any capacity? Yes No

Are you seeking full or partial coverage of costs? Are you seeking full or partial coverage of costs? Full Partial