CAST-NC Membership Application Form (fields in red are required field)
First Name
Last Name
Employer
Job Title
Highest Degree
Major
Year
Professional specialties (separate different specialty by "," e.g. drug formulation,informatics)
Street		Apt
City		State/Province
Zip/Postal Code		Country
Work Phone		Home Phone
E-mail		Fax
Membership Fee (click one only)	Regular ($20)   Student ($10)   Couple ($30)   Permanent ($200)
Make your check (US fund) payable to CAST-NC and mail to: CAST-NC P.O. Box 1013 Cary, NC 27512