You can print this form out (or you can ask NASA @ 439-3181 to send you one).
Fill out the application and send it to the address below.
Membership also entitles you to library privileges, access to the phys ed facilities and health services.
Send to: NASA, Room 7-50, University Extension Centre, 8303-112 Street, U of A (via Campus Mail)

Go to Trust Start Page

APPLICATION FOR NASA MEMBERSHIP
(Please Print in Block Letters)

______________________________________	______________________	______________
Last Name				First Name		Middle Initial

_____________________________________________________		____________________
Department							Work Phone # 

_____________________________________________________		____________________
Department Address 						email

_____________________________________________________

_____________________________________________________		____________________
Home Address				(Postal Code)		Home Telephone # 

______________________________	____________	______________________________
Date of Birth			Gender (M/F)	Date of your first appointment 

I, ____________________________________, hereby apply for membership in the University 
of Alberta Non-Academic Staff Association. I understand that in so doing I select NASA
as my sole bargaining agent with the University of Alberta.

Dated at Edmonton on
 

______________________________________________	____________________________________________
Day		Month			Year	Signature 

Correspondence from NASA should be sent to your:    Home [ ]	Department [ ]