Regular Membership, New or Renewal ($10.00)

Student Membership, New or Renewal ($5.00)

Emeritus (NO charge.  Just return this completed form.)

Name / Title of Member  

Address

Phone

Fax

Email Address

Web Address

Microscopy Interest

I Do Not wish to be included on any mailing lists that CSMMS makes available to Corporate Members.

Please send a formal receipt; my cancelled check or credit card statement is insufficient for this purpose.

I am also a member of:

Corporate Membership, New or Renewal ($75.00)

CENTRAL STATES MICROSCOPY AND MICROANALYSIS SOCIETY

2009 MEMBERSHIP APPLICATION

Membership Category Desired

Special Requests (Check all that apply)

Welcome to our Society and thank you for your continued involvement  in Central States Microscopy and Microanalysis Society!

Payment Options

Pay by Check- Mail Application

Please make checks payable to "CSMMS". Print form and send both form and check to:

Cheryl Jensen

Secretary, CSMMS

University of Missouri

W125 Veterinary Medicine

Columbia, MO 65211

Pay Using Pay Pal- Click Submit button below to sumbit your form, and the Paypal button to make your payment.