- Email: [email protected]
Membership Application Form
Toxicon 49 (2007) I–II www.elsevier.com/locate/toxicon
For the convenience of our readers, there is reprinted below the official application form for membership in the International Society on Toxinology. Those who have published original scientific research on animal, plant and microbial toxins are eligible for full membership, while those with an interest in natural toxins, but lacking original research publications can apply for associate membership. If you do not know a present member of the Society to sponsor your nomination, please send the completed forms to Dr. Mebs, who will arrange for sponsorship of worthy candidates. The Society has currently well over 500 members worldwide, publishes a Newsletter, sponsors the Redi Award in toxinology and organizes regional and international congresses and meetings. Yearly dues are US $135.- and include a subscription to Toxicon (16 issues per year) or are US $30.- for those who have access to Toxicon (full text) through http:/www. sciencedirect.com; students are free, their application should be accompanied by a short note of their supervisor. I apply for full [
], associate [
], student [
] membership;
My yearly dues should include a subscription to Toxicon and are US $135 [ ] I have access to Toxicon through http:/www.sciencedirect.com, my dues are US $ 30 [ ] I am a student (supervisor’s note enclosed) and will not receive a subscription to Toxicon [
]
The completed form should be sent to the Secretary-Treasurer of the Society: Prof. Dr. Dietrich Mebs Zentrum der Rechtsmedizin University of Frankfurt Kennedyallee 104 D-60596 Frankfurt, Germany FAX: +49 69 6301 5882, e-mail: [email protected] 1. Full name (please print): ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Last First Middle 2. Business address: -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Phone:
FAX:
e-mail:
3. Home address: -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Phone:
FAX:
e-mail:
4. Date and Place of birth: ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------month day year city country:
Please, add a short curriculum vitae and a list of your publications 5. Nominated by: (only requested for full membership) ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name and address: --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------Signature of nominating member Date:
---------------------------------------------------------------------------------------------Signature of applicant
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------For official use only [
] Approved
[
] Disapproved
For the convenience of our readers, there is reprinted below the official application form for membership in the International Society on Toxinology. Those who have published original scientific research on animal, plant and microbial toxins are eligible for full membership, while those with an interest in natural toxins, but lacking original research publications can apply for associate membership. If you do not know a present member of the Society to sponsor your nomination, please send the completed forms to Dr. Mebs, who will arrange for sponsorship of worthy candidates. The Society has currently well over 500 members worldwide, publishes a Newsletter, sponsors the Redi Award in toxinology and organizes regional and international congresses and meetings. Yearly dues are US $135.- and include a subscription to Toxicon (16 issues per year) or are US $30.- for those who have access to Toxicon (full text) through http:/www. sciencedirect.com; students are free, their application should be accompanied by a short note of their supervisor. I apply for full [
], associate [
], student [
] membership;
My yearly dues should include a subscription to Toxicon and are US $135 [ ] I have access to Toxicon through http:/www.sciencedirect.com, my dues are US $ 30 [ ] I am a student (supervisor’s note enclosed) and will not receive a subscription to Toxicon [
]
The completed form should be sent to the Secretary-Treasurer of the Society: Prof. Dr. Dietrich Mebs Zentrum der Rechtsmedizin University of Frankfurt Kennedyallee 104 D-60596 Frankfurt, Germany FAX: +49 69 6301 5882, e-mail: [email protected] 1. Full name (please print): ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Last First Middle 2. Business address: -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Phone:
FAX:
e-mail:
3. Home address: -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Phone:
FAX:
e-mail:
4. Date and Place of birth: ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------month day year city country:
Please, add a short curriculum vitae and a list of your publications 5. Nominated by: (only requested for full membership) ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name and address: --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------Signature of nominating member Date:
---------------------------------------------------------------------------------------------Signature of applicant
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------For official use only [
] Approved
[
] Disapproved