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AIAS Application Form

Please use the form below to apply for an Academy of Interactive Arts & Sciences Individual Membership. PLEASE NOTE: Your submitted application below will not be active until we have approved it. At that time you will receive an email with further instructions.

ACCOUNT INFORMATION
Account Name (Email): *
  Re-type Account Name (Email): *
Password: *
  Re-type Password: *
First Name: *
  Last Name: *
Email Alert: *
Have an Automated Email Alert be sent when account your information is changed.
 
COMPANY INFORMATION
Company Name:
  Company Organization:
Job Title:
   
 
Phone:
  Fax:
Mobile:
   
 
Street 1:
  Street 2:
City:
   
State:
  Province:
Zip:
  Country:
 
PERSONAL INFORMATION
DOB:
   
Email:
  Phone:
Mobile:
  Fax:
 
Street 1:
  Street 2:
City:
State:
  Province:
Zip:
  Country:
 
EXPERTISE INFORMATION
Primary Area of Expertise:
  Year Started In Industry:
List of Game Titles:

EX: Call of Duty, Grand Theft Auto IV, Zelda
  Year Started Current Position:
 
DICE SUMMIT ATTENDANCE
1997: *
1998: *
1999: *
2000: *
2001: *
2002: *
2003: *
2004: *
2005: *
2006: *
2007: *
2008: *
2009: *
2010: *
2011: *
2012: *
2013: *
2014: *
2015: *