Account Login Information
User ID
Your User ID will be your membership (account) number
Create Password
Contact Information
Please provide the following application information. Fields marked with an * are required.
Salutation
Dr.
Mr.
Mrs.
Ms.
Mx.
Prof.
First Name*
Middle Name or Initial
Last Name*
Suffix (Jr., Sr., etc.)
Achieved Degrees
Select no more than 3 of terminal (highest achieved) degrees. Select only if terminal degree (highest degree you plan to achieve).
Current Position*
Address Type*
Home
Work
Organization*
Type of Organization*
For-Profit (Corp or Business) Government (excluding NIH) Hospital/Health Care NIH Non-Profit (excl Hosp/Health) Other Publishing Research Insititute-Non Govt University/Academic
Department/Address 1*
Address 2
Address 3
City*
State/Prov.(US/Canada)
Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territory Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Out of country Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory
Required for US/Canada addresses only.
Province
Zip/Postal Code*
Country*
Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Islands Costa Rica Cote D'Ivoire Croatia Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And South S.S. South Korea Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Minor Islands Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe
Telephone Number*
*US/Canada: Type only the area code and number - parentheses and dash will appear. 3016347195 will appear as (301)634-7195 ).+ country code and number, (e.g., +13016347195 ).
Fax Number
Email Address*
For example, me@name.com
Institutional/Professional Web Address
URL of the faculty, lab, or other web page best describing your work
Career Level
Please check appropriate Career Level*
Faculty or Equivalent Graduate Student Postdoctoral Fellow Undergraduate Student Young Professional TraineeWithin 5 years of completing undergraduate degree—not enrolled in a graduate program.
All trainees must include the name and email of their advisor (someone who can attest to your trainee status).I expect to receive a/an* I received a/an* Enter the 4-digit year* )
Professional Degree(s), Institution & Year (choose up to 3 starting with most recent degree)
Voluntary Demographics
AAI is committed to ensuring a safe and welcoming environment for all members regardless of race, skin color, religion, national origin, gender, gender identity or expression, sexual orientation/preference, age, military or veteran status, marital status, or disability. To best serve our membership, we ask you to complete these basic demographic questions. Your answers are confidential, and will never be shared with third parties. Participation is voluntary.
Date of Birth (MM/DD/YYYY)
Gender
Ethnicity (U.S. Citizens / Permanent Residents ONLY)
African American Alaskan Native Native American Asian American Caucasian/White Hispanic American Native of U.S. Pacific Island Prefer to identify as... Prefer not to answer
