Application for Membership

First Name *
Last Name *
Address
*
City *
State/Province *
Zip/Postal Code *
Phone *
E-Mail
Pen/Publication Credit Name
I _____ want my contact information to appear in the Academy Directory DO     DO NOT     *
I _____ want my name to be places on manufacturers comp lists. DO     DO NOT     *
I _____ want my contact information to appear in the online directory. DO     DO NOT     *
For publications in the Academy Directory (please check all that apply) Designer
Editor
Developer
Writer
Play-tester
Illustrator
Graphic Designer
Sculptor
Owner/Manufacturer
Employee/Manufacturer
Owner/Retail
Employee/Retail
Owner/Distributor
Employee/Distributor
Marketing
Available for freelance
Available for consulting
Current Position in industry
Including Title and Employer
Personal Accomplishments

Non-product awards and recognition (include dates)
Most Significant credits (limit six, list at least three)
*
Type of credit, Product, Publisher/Manufacturer, Year and Awards for each product listed
College Selection One *
Please select your AAGAD College
College Selection Two *
Please select your AAGAD College
College Selection Three *
Please select your AAGAD College
College of Exceptional Games Yes     No    
For Vanguard and like awards
College of Game Resources Yes     No    
Open to all academy members
Membership Type New Supporting
New Non-Supporting
Renewal - Supporting
Renewal - Non-Supporting
*