Sigma Xi Affiliate Circle
Enrollment Form

Select Your Sigma Xi Affiliate Category: *

Professional: Individuals who work or have earned a degree in science or engineering, or non-scientists or engineers who support the role of science and technology in society.

College or University Student: Degree seeking students in post secondary education institution (community college, college or university)

Student in Grades K-12: K-12 students with interest in science, technology, engineering or math.

Do you have promo code? *

Yes

No

Please enter your promo code below in order to recieve your free American Scientist mug:

Prefix: *

First Name: *

M.I.

Last Name: *

Suffix:

Email Address: *

Daytime Phone #: *

Date of Birth (mm/dd/yyyy): *

Gender:

Ethnicity:

Mailing Address

Address Type: *

Home Address

Business Address

Country: *

Address Line 1: *

Address Line 2:

City: *

State:

State: *

Province: *

Zip Code: *

Education Information:

Name of School: *

City: *

State: *

Degree You Are Seeking: *

Other Degree: *

Expected Graduation Date:

Graduation Month: *

Graduation Year: *

Professional Information:

Highest Degree Attained: *

Other Degree: *

Company/Institution: *

Discipline: *

Other Discipline: *

Job Title: *

Other Job Title: *

Chapter Affiliation

Select the Sigma Xi chapter you would like to affiliate with:
(If no affiliation is desired, select 'Membership At Large') *

Privacy Policy

Please indicate your mailings preference: *

I agree to receive mailings from all organizations that Sigma Xi feels may be of interest.

I only want to receive mailings from Sigma Xi.

Please do not use my address for marketing. I understand that I will still receive mailings related to my Affiliate Circle Membership.

American Scientist Magazine

Your Sigma Xi Affiliate membership dues include one year of American Scientist magazine. Please indicate which format of American Scientist magazine you'd prefer to receive:
*

Print Version

Digital Version

Your Sigma Xi Affiliate membership dues include one year of the digital version of American Scientist magazine. You may elect to instead receive the print version of American Scientist magazine for an additional $10.00 charge.
Please indicate which format of American Scientist magazine you'd prefer to receive:
*

Digital Version (No additional charge)

Print Version (Additional $10.00 charge)

Affiliate Circle Dues

Professional Affiliate: *

Professional Affiliate: US $55.00 (Expires on June 30, 2025)

Student Affiliate (College/University): *

Student Affiliate (College): US $40.00 (Expires on June 30, 2025)

Student Affiliate (K-12 Grade): *

Student Affiliate (K-12): US $25.00 (Expires on June 30, 2025)

American Scientist Magazine- Print Version: *

American Scientist magazine print version: US $10.00

Current Total:

$0.00

Sigma Xi Affiliate Circle Enrollment Form