ANAEROBE SOCIETY OF THE AMERICAS, INC.
Membership Application and Renewal

Membership dues cover the annual periods of January thru December, starting 2010
Members will have the options to receive the ANAEROBE Journal via the Internet or
print edition via mail, for extra fees.

MEMBERSHIP CATEGORIES

:
DOCTORIAL DEGREE
2-Year Membership with: No Journal-$135 Journal via Internet-$145 Print Journal-$165
1-Year Membership with: No Journal-$85 Journal via Internet-$90 Print Journal-$100

NON-DOCTORIAL DEGREE
2-Year Membership with: No Journal-$70 Journal via Internet-$80 Print Journal-$100
1-Year Membership with: No Journal-$45 Journal via Internet-$50 Print Journal-$60

RETIRED-Past Members
2-Year Membership with: No Journal-$50 Journal via Internet-$60 Print Journal-$80
1-Year Membership with: No Journal-$35 Journal via Internet-$40 Print Journal-$50

STUDENTS/POST DOCS
1-Year Membership with: No Journal-$35 Journal via Internet-$40 Print Journal-$50
Proof of student or post-doc status needs to be mailed to ASA.

PAYMENT METHOD
Mail check in $US.
Credit Card: VISA - MasterCard - American Express
      Number:   Expiration MM/YY:

This form will be processed when payment is received.
ASA Tax ID # 95 4388236

PERSONAL INFORMATION

Title: Name: Degrees:
Mailing Address:
     
     
     
     
     

Telephone: Fax:

Email:

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Send Inquiries to Webmaster: asa@anaerobe.org