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Membership in AAKSIS entitles your household to our newsletter, KaleidoScope, as well as discounts on registration for the annual meeting. The annual dues of $25 help defray the cost of printing and mailing the newsletter and of maintaining the organization and its web-site.

If you wish to become a member, please complete and mail the registration form, along with a check or money order for your registration and any additional donation that you wish to make. You are entitled to a copy of the current newsletter when your membership fee is received.

At the bottom of the form please indicate whether you need the newsletter mailed or would prefer an electronic mailing in Acrobat PDF format. Clicking the submit button takes you to a page with all the information listed that you will type in the form below. That page can be printed, and then mailed to the address that is listed on it, with the $25 membership fee. Thank you for becoming a member of AAKSIS.


All information provided is strictly confidential. Please read our Privacy Policy, and please do not share any information that would make you uncomfortable.


*First Name:
*Last Name:
*Telephone Number:
*Which Family member is XXY or Variant?
*Date of Birth if XXY or Variant?
(date form:6/19/2005)
*Date of Diagnosis of XXY or Variant?
(date form:6/19/2005)
*Street Address:
*City:
*State or Province:
Other state or province:
*Country:
*Postal or ZIP code:
*E-mail address:
Please check either yes or no to indicate whether you need a hard copy of the newsletter mailed to your home: NO:  

YES:




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