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ONLINE REGISTRATION
Membership Application Form (doc)   Membership Application Form (pdf)
Korean-American Scientists and Engineers Association(KSEA)
1952 Gallow Road, Suite 300, Vienna, Virginia 22182
Tel: (703) 748-1221, Fax: (703) 748-1331
E-mail: sejong@ksea.org, Web: http://www.ksea.org
KSEA MEMBERSHIP REGISTRATION -> GENERAL INFORMATION 
* Koreans or Korean-Americans in the US are eligible for a KSEA MEMBERSHIP. An application by an ineligible person will be cancelled without notice. 
 PERSONAL INFORMATION
Name
*Title
 *First Name
 Middle Name
 *Last Name
Other Names
  Korean First Name
 Korean Last Name
 Chinese Name
Gender
DOB  [mm/dd/yyyy]
Birth Place
Citizenship
Picture
*Member Type
*Chapter
Technical
Group
Specialty
* Login ID
* Examples: ksea2003, khl2003, finance@ksea.org (MAX 30 characters)
* You will use this login ID to access the information on the ksea.org website.
* password (Max Length = 20)      Confirm
 HOME INFORMATION
Home Address
Street*
 		 City*
 		 State*
Province
 Zip*
 Country*
*Primary Email
Homepage 
Phone Numbers
*Home
 Home Fax
 *Mobile
  EDUCATION INFORMATION
*Highest Degree
Degree*
 Year Earned*
[YYYY]
*Major
*School Name
Thesis Title
 WORK INFORMATION (Student members can enter school information here)
*Keywords to Represent Your Expertises (e.g. Chemistry, Math, Computer Science)
*Affiliation(School, Company)
Department
 Job Title
Work Address
Street
 		  City
 		 State
Province
 Zip
 Country
*Work Email
Work URL 
Phone Numbers
*Work
 Work Fax
Prefered Contact
* - Required Field
* - One of the fields is Required


© 2006 Korean-American Scientists and Engineers Association. All rights reserved.