application for individual membership
TRANSCRIPT
International Association of Geochemistry and Cosmochemistry
Application for individual membershipTITLE: Dr.[ ] Prof.[ ] Mr.[ ] Mrs.[ ] Ms.[ ] Other(specify)
FAMILY NAME:
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TYPE OF INSTITUTION:University [ ] University Institute [ ] Government [ ] Private []Other (specify) [ ]
IPOSITION IN INSTITUTION:
IPROFESSIONGeochemistry [ ] Geology [] Chemistry [ ] Other (specify) [ ]
PAYMENT SHOULD ACCOMPANY APPLICATION FORM; CHEQUE/MONEY ORDERPAYABLE TO 'IAGC IN TRUST'. WE DO NOT ACCEPT CREDIT CARD PAYMENTS.
IAGC MEMBERSHIP DUES: $10.00US PER YEAR; [](LIFETIME MEMBERSHIP AVAILABLE AT $150.00US) []
SUBSCRIPTION RATE FOR APPLIED GEOCHEMISTRY $18.00US []
PLEASE FORWARD COMPLETED FORM AND CHEQUE OR MONEY ORDER TO:
Dr. Brian HitchonSecretary, IAGeAlberta Research CouncilPO Box 8330, Station FEdmonton, AlbertaT6H 5X2, Canada