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AIAS Application Form

If you work for one of our corporate members, please contact Claudio Tapia by email about joining the Academy. 

To inquire about corporate membership and its benefits for your company, contact Claudio Tapia at (310) 484-2559 or by email.

If you have any questions feel free to contact us.

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: *
2016: *
2017: *
2018: *