Student Application

First Name

Last Name

Address Line 1

Address Line 2

City

State

ZIP/Postal Code

If you are located outside the United States, please provide your State/Territory and Country

Email Address

Phone Number

School Name

Student ID #

Expected Graduation Date

I agree to complete the AGS 101 course within ten days of enrollment. *

I acknowledge, by digitally signing below, that I have read and understand the requirements and annual membership dues for Individual membership. I certify that the information provided is complete, true, and accurate. I understand that the accuracy of this information and the ability to verify it are required for membership. I authorize any verification needed into the information provided. If approved for membership, I agree to abide by the Policies, Standards, and Bylaws of the American Gem Society. *

Signature:

Date:

Student Application

Mission Statement

American Gem Society