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ASC Membership Form

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					                                    Association of Students in Communication

                                                        Membership Form


                             Thank you for your interest in joining the Association of Students
                             In Communication (ASC) at the College of Southern Nevada
                             (CSN).

                         To become a member of ASC you have to have a current CSN student
                         ID. If you do not have one, you need to visit any student government
office at the Cheyenne, Henderson, or West Charleston campuses along with $2.00 in order to
obtain your ID. Please enclose a photocopy of your current CSN ID with your membership form.

Next, please print out this form and provide us with the following information to better serve
you. Please print clearly. Bring this completed form and a copy of your CSN Student ID to any
of the faculty advisors or to the communication department office. ASC Faculty Advisors: Jodie
Mandel, W. CH C-151-A27 (651-5503) or Michele Fogg, W. CH E-251 (651-7422). ASC Advisory
Committee: Kim Huff, W. CH B150-C (651-7567) or Owen Pillion, Cheyenne 1427-H (651-4048).

_____________________________________________________________________________________________
First Name                                                  Last Name
_____________________________________________________________________________________________
Current Street Address
_____________________________________________________________________________________________
City                                                        State                   Zip Code
_____________________________________________________________________________________________
Home Phone                                                  Cell Phone
_____________________________________________________________________________________________
Email Address
_____________________________________________________________________________________________
CSN Campus you attend most frequently                       Major

_____________________________________________________________________________________________
Please list your availability for attending ASC meetings

_____________________________________________________________________________________________
Future Career Plans

Which of the following committees/areas would you be interested in? Please circle
Event Planning                    Social                    Networking              Road Trip
Canned Food Drive                 Community Service         Fundraising             Communication Seminar
Internships                       Leadership                Career Workshops        Other ________________

Feedback/Comments: ___________________________________________________________________________
_____________________________________________________________________________________________
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