Individual Membership Application

Types of Membership:

Individual Membership - $60.00 annually - Benefits include quarterly SAFE Newsletter, annual SAFE proceedings, all SAFE-related mailings throughout the year, and reduced registration rate at the annual SAFE Symposium.

Full Time Student Membership - $10.00 annually - (Student I.D. required) - Benefits: Same as Individual Membership

Retired Membership - $20.00 annually - These persons must not be engaged in any form of consulting, part-time, or paid work in any form. Benefits: same as Individual and Student Membership except does not allow for special symposium registration rates.

Check payment can be mailed to:
SAFE ASSOCIATION
Post Office Box 130
Creswell, OR 97426-0130
Phone: (541) 895-3012
FAX: (541) 895-3014
E-mail: safe@peak.org

Complete the online application below or fill out our Individual Membership Application (PDF).

Online Individual Membership Application Instructions:

Step One - Complete this page with your information
Step Two - Click on the "Continue to Payment Information" button. If you are paying by credit card you will be presented with the Credit Card Payment entry form on page two; otherwise, you will receive specific instructions for the payment method that you choose.

= Required Fields

Individual Membership Application Form

Mr./Ms.,Military Rank, Dr.,etc:

First Name:

Last Name:

Middle Name/Initial:

Organization/Company:
(if applicable)

Job Title:
(if applicable)

Mailing Address Line 1:

Mailing Address Line 2:
(if applicable)

If located in the U.S., please enter your Zip Code:

City:

Country:

State:

Province:

Foreign Postal Code:

Telephone Number:

Email Address:

Would you like for your information to appear in the online SAFE Membership Directory?
(your information is viewable by SAFE Members only)

Yes, I would like to appear in the Membership Directory

No, I would not like to appear in the Membership Directory

If you are a chapter member please select your chapter:
(Hold Control or CMD Key for Multiple Selections)

Membership Rates:
(Choose one)

Individual Membership - $60.00 annually - Benefits include quarterly SAFE Newsletter, annual SAFE proceedings, all SAFE-related mailings throughout the year, and reduced registration rate at the annual SAFE Symposium.

Full Time Student Membership - $10.00 annually - (Student I.D. required) - Benefits: Same as Individual Membership

Retired Membership - $20.00 annually - These persons must not be engaged in any form of consulting, part-time, or paid work in any form. Benefits: same as Individual and Student Membership except does not allow for special symposium registration rates.

Payment Method: