Management Science Institute
Membership application

Today's date:

-- mm/dd/yy

Please provide the following contact information:

First Name
Last Name
Middle Initial
Date of Birth
Sex	Male Female
Organization
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
Web site URL

Education (select all that apply):

Some high school	Baccalaureate degree
High school graduate	Master's degree
Some college (no diploma or degree)	PhD degree
College certificate (non-degree diploma)	Juris Doctor (or similar)
Associates degree	Medical Doctor
Trade school diploma graduate
Technical school diploma graduate	Other

Citizenship:

What are your main areas of expertise (select all that apply):

Annual income (USD):

Less than $20,000 $20,000 - $30,000 $30,000 - $40,000 $50,000 - $60,000 $60,000 - $70,000 $70,000 - $80,000 $80,000 - $90,000 $90,000 - $100,000 $100,000 - $125,000 $125,000 - $150,000 $150,000 - $175,000 $175,000 - $200,000 $200,000 - $250,000 $250,000 - $300,000 $300,000 - $350,000 $350,000 - $400,000 $400,000 - $500,000 $500,000 - $750,000 $750,000 - $1,000,000 More than $1,000,000

Please tell us your reasons for wanting to be a member of Management Science Institute?

Tell us anything else about yourself that may be of interest to other members.

 

Have you read, and do you understand, the MSI Charter?
You must answer this question. Your application may be rejected if the question is not answered in the affirmative.

Yes No