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APPLICATION FORM FOR PERSONAL MEMBERSHIP

Personal Membership: $50 / year or $100 / 3 years paid in advance.

You may apply for membership to the International Isotope Society by submitting this form electronically. Fill out the form and click the SUBMIT button. All cheques, bank drafts, etc. should be made payable to the INTERNATIONAL ISOTOPE SOCIETY, INC.. Please mail a printed (print from the FILE menu) copy of this form along with the payment in the usual fashion to:

David Hesk
Executive Secretary, IIS
Schering Plough Research Institute
2015 Galloping Hill Road
Kenilworth, NJ 07033-1310
United States

Once your form and check have been received, you will be notified of your membership. Thank you for your request and interest.

Note: The INTERNATIONAL ISOTOPE SOCIETY, INC. is a fully incorporated and registered professional society in the State of New Jersey, USA. (Date registered: November 24, 1986).

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Please review your entry and check for input errors. When you are satisfied with the information, submit the form by clicking the Submit button below. If you wish to reset the form to its original values and start over, press the Clear Form button. To print out a copy of the form to send with your payment, select the print function on your web browser.

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