IASPRR - Membership Form

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Enter professional information

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Finished

If you would like to join, please answer the questions in this form and submit it to the Secretary, IASPRR.
The field marked with * have to be filled in.

Personal information
Surname (family name)*:
Middle name:
First name (given name)*:
Title (Mr., Mrs., Dr. Prof., etc.):
Institute:
Street*:
City*:
Postal code*:
State or Province:
Country*:

Telephone number:
Fax number:
Email*:

Membership and payment
Type of membership (select one):	Individual member (Annual fee: €30.- ) Student member (Annual fee: €15.- ) Corporate member (Annual fee: €100.- ) Lifetime membership (€300.- )
Prepayment:	I want to pay the fee for years in advance.
	When registering for the first time as a member, the payment for a 2-year membership is required to simplify the database record keeping.

Do not share my data with other members.

(Your data will not yet be submitted.)