THE CRUSTACEAN SOCIETY

Application for Membership

Download form in application form.rtf

(Please print the form, fill it in, and send by snail-mail to the address at the bottom)


Name (title, last name first)_____________________________________________

Mailing address for Society communications (Please condense to no more than 3 lines, 40 characters per line, maximum)

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Tel: (include area code) _____________  Fax: (include area code)_______________

e-mail address:_________________________

Type of membership and annual dues:

     ___  Student Member* (with journal)...............................$65
     ___  Member (no journal)..........................................$35
     ___  Member (with journal)........................................$95
     ___  Patron Member (journal).....................................$125
     ___  Institutional Journal Subscription..........................$145
     ___  Foreign Institutional Journal Subscription..................$165
     ___  Denton Belk Memorial Endowed Fund Contribution..............$______
     ___  Voluntary assessment to support TCS activities..............$______
  Total enclosed......................................................$______

* Individuals claiming student rates are asked to provide your mentor's name______________________. 
   Mentor does not have to be a member. Members wishing to claim financial hardship may write to The Secretary, 
   The Crustacean Society, for reduced rates. 


Starting Year_________ (includes all issues for this year)

Personal check enclosed___ Mastercard___ Visa___

Card No.________________________________________________________

Expiration Date_________________________________________________

Signature_______________________________________________________

Send completed application form and payment in U.S. dollars to:

Business Office, The Crustacean Society, P.O. Box 7065, Lawrence, Kansas 66044-7065, Phone: (785) 843-1221, FAX: (785) 843-1274.

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