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         *


I _____ want my name to be places on manufacturers comp lists.         *


I _____ want my contact information to appear in the online directory.         *


For publications in the Academy Directory (please check all that apply)



















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        
For Vanguard and like awards

College of Game Resources        
Open to all academy members

Membership Type



*