New Membership__________________Renewal Membership_____________________
Name__________________________________________________________________
Address________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Phone: ______________________________Fax:_______________________________
Date: _____/_____/_____ E-Mail _______________________________
Area(s) of Interest:
_____________Biological Sciences
_____________Physical Sciences
Type of Membership
_____________Regular 1 yr. $10.00; 2 yr. $20.00; 3 yr. $30.00
_____________Student 1 yr. $5.00
_____________Corporate 1 yr. $50.00
Please make checks payable to: FLORIDA SOCIETY FOR MICROSCOPY, please include year(s) dues are for (2003,etc). Do not send cash. Thanks.
Mail completed forms and payment to:
Last updated Friday, 18-Jan-2008 08:11:31 CST
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