D IVISION & I NTEREST G ROUP C HANGE FORM
NAME:
MEMBER ID:
DIVISION AND INTEREST GROUP ADJUSTMENTS
(no charge to switch one division/interest group for
another): PLEASE USE ACRONYMS (see Section 2)
1
Current Selection(s):
New Selection(s):
DIVISIONS AND INTEREST GROUP ADDITIONS: YOUR DUES PAYMENT ENTITLES YOU TO (2) COMPLIMENTARY DIVISIONS OR INTEREST GROUPS.
2
You may choose to purchase additional (more than two) divisions/interest groups. Additional divisions are $11.00 each. Additional Interest Groups are $7.00 each.
Please check your ADDITIONAL choices below.
3
Business Policy and Strategy (BPS)
CHOOSE ANY TWO
Management Consulting (MC)
Organizations and The Natural Environment (ONE)
Careers (CAR)
Management Education and Development (MED)
Public and Nonprofit (PNP)
Conflict Management (CM)
Management History (MH)
Research Methods (RM)
Critical Management Studies (CMS)
Managerial and Organizational Cognition (MOC)
Social Issues in Management (SIM)
Entrepreneurship (ENT)
Operations Management (OM)
Technology & Innovation Management (TIM)
Gender & Diversity in Organizations (GDO)
Organization and Management Theory (OMT)
Health Care Management (HCM)
Organization Development and Change (ODC)
INTEREST GROUPS
Management Spirituality & Religion (MSR)
Human Resources (HR)
Organizational Behavior (OB)
Strategizing Activities and Practice (SAP)
International Management (IM)
Organizational Communication & Information
Systems (OCIS)
ADDITIONAL DIVISIONS/INTEREST GROUPS (If you chose more than two, you must pay an additional fee. Be sure to indicate your selections above)
4
EXTRA Divisions @ $ 11.00 each . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...
$
EXTRA Interest Groups @ $ 7.00 each . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
TOTAL AMOUNT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
CREDIT CARD PAYMENT (Check Type)
VISA
MASTERCARD
CARDHOLDER NAME:
(please print)
CREDIT CARD NUMBER:
(please print legibly)
AMERICAN EXPRESS
* CARD SECURITY CODE
*
EXPIRATION DATE:
/
SIGNATURE OF CARDHOLDER: ___________________________________________________________________________________________
* CARD SECURITY CODE: For VISA or MasterCard cardholders, these are the last 3 numbers found on the back of the card in the signature panel.
For American Express cardholders, these are the additional 4 numbers printed on the front of the card.
OTHER FORMS OF PAYMENT ACCEPTED: (Payable in U.S. Dollars Only)

PERSONAL CHECKS drawn on U.S. banks or U.S. bank affiliates
made payable in U.S. dollars to: ACADEMY OF MANAGEMENT

International bank money orders
5
FOR OFFICE USE ONLY:
Date Received:
TOTAL ENCLOSED:
Total Divisions from Section 2 (Additional Divisions @ $11.00 each) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Total Interest Groups from Section 6 (Additional Interest Groups @ $7.00 each) . . . . . . . . . . . . . . . . . .
$
TOTAL AMOUNT ENCLOSED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
TO SUBMIT THIS Division/Interest
Group Change Form: (with payment)
6
OTHER PROFILE UPDATES:
Mail:
$
The Academy of Management
P.O. Box 3020
Briarcliff Manor, NY 10510-8020
U.S.A.
Check #
Amount Paid:
Credit Approved:
Call: (914) 923-2607
Fax: (914) 923-2615
E-mail: membership@aom.org
ADDRESS:
S
AFFILIATION:
ADDRESS:
C
E-MAIL:
CITY:
P
PHONE:
COUNTRY & POSTAL CODE:
Thank you!
You will receive an email confirmation of the changes made to your Division and Interest Group selections once they are processed.
You can verify your account information by logging in to your Academy Profile.