Welcome to the
Microscopy Society of America's
Electronic Sustaining Membership Application Form.

Thanks for your interest in becoming a Sustaining Member of the Microscopy Society of America.

You can read a summary about the Benefits of becoming a Sustaining Member . after which we invite you to use the electronic form below to submit your application to support the society.

After you have completed the form you may either submit it via the WWW or print out the form on your local printer and then send it by conventional post to the MSA Business Office. Although we provide a section of this form for you to submit your credit card number, please note that credit card transactions over the Internet may not be secure. If you choose, you may at your option telephone or fax the Business Office with your credit card information. If you choose to post your form with your payment, we ask that you still submit the form via the WWW in order that we have an electronic copy of your data sheet. There is an option in the form below which allows you to indicate how your membership payment is being transmitted.


MSA Business Office
230 East Ohio Street, Suite 400
Chicago, IL 60611-3265
Toll-free: 1-800-538-3672
Tel: 312-644-1527
Fax: 312-644-8557
Email: BusinessOffice@MSA.Microscopy.Org

Microscopy Society of America

New Sustaining Member Application Form
* Indicates a required field
Organization:*
Address Line 1:*
Address Line 2: 
Address Line 3: 
City:*
State:*
Zip:*
Country:*
Phone: 
Fax: 
E-mail address: 
WWW address: 
Contact Info:
 Last/Family Name: *
First Name: *
Middle:   



Brief Description of your Organization, its Services and/or Role in Microscopy and Microanalysis: 
Email News: 
 Would you like to receive MSA related News by Email?
Yes     No
Select Membership Type: *
Membership Opportunities (Select one)

Regular Member [North America - US/Canada/Mexico] $375 Annually
International Member [Outside of North America] $393 Annually

Select Payment Method:
for this Transaction*

Choose Your Method of Payment
for this Transaction.
Note: Membership will not be conferred until all information is verified
and payment is received by the Society.

I will mail a Check to the Business Office
I wish to pay On-Line by Credit Card ( Visa/MasterCard)
     Warning: Submitting Credit Card information via the WWW may not be secure.
     You may choose to phone/fax in your credit card information if so desired.
  • Credit Card Number
    Visa
    MasterCard
    Expiration Date

I will FAX in Credit Card Information to the Business Office
I will Phone in Credit Card Information to the Business Office

Checks must be in US Dollars drawn on a US Bank
For those who wish to Mail the Application Form and Payments
Please use the following address:

MSA Business Office
230 East Ohio Street, Suite 400
Chicago, IL 60611-3265
Toll-free: 1-800-538-3672
Tel: 312-644-1527
Fax: 312-644-8557
Email: BusinessOffice@msa.microscopy.org

Help: 
 Would you like someone from MSA to contact you to answer a membership question?
Yes     No

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Note: After clicking the Submit Button above it may take a few minutes to process your application
please wait for the acknowledgement form to appear on your screen before continuing.

Nestor J. Zaluzec / Zaluzec@Microscopy.Com