(Please print legibly or
type)
This is a (1) New Membership,
(2) Student Membership, or (3) Renewal Application (circle one)
Name:______________________________________________ Date of Birth___________
Mailing Address:_______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Present Position: _________________________________________________
Name of Institution: ______________________________________________
Phone:_________________________________ FAX:__________________________________
E-Mail:__________________________________
Highest Degree Earned and the Year Received:___________________________
Are You a Student? If so, for what degree and where?______________________________
_______________________________________________________________________
Field(s) of interest:_________________________________________________________
_______________________________________________________________________
If you are experienced in your field, would you consent to serve as a reviewer for manuscripts submitted for publication in Comparative Parasitology? If so, what specific subject area(s) do you feel most qualified to review? ______
___________________________________________________________________________
__________________________________________ _________________
Signature of Applicant and Date:
___________________________________________________________
Signature of Major Professor (for Student Applicants) or Sponsor (a member)
Mail the completed application along with a check (from a US bank) or money order (in US currency) for the first year's dues (U.S.$32 for domestic members, $16 for students or US $35 for foreign members) to the Corresponding Secretary-Treasurer, Sherman S. Hendrix, Dept. of Biology, Gettysburg College, 300 N. Washington St., Gettysburg, PA 17325. If you wish to pay by credit card (Visa and Master Card only), please complete the following: