THE ELECTROPHORESIS SOCIETY

Promoting scientific advancement
in electrophoretic theory and applications

MEMBERSHIP APPLICATION

Benefits include meetings, conference discounts, newsletters, and database directory. Please complete the information below and send to the address below. [To print this form in Netscape, click in the browser window with the form and then select Print Frame from the File menu.]

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Mr. Ms. Dr.   First Name      M-Initial  Last Name                Degree(s)


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DUES PAYMENT
_____ Full Member $50.00 _____ Student Member $25.00

Payment may be made by check in U.S. dollars and drawn upon a U.S. bank or by MasterCard or Visa. Please make checks out to THE ELECTROPHORESIS SOCIETY and mail to:

THE ELECTROPHORESIS SOCIETY
Joan Stevenson, Executive Director
The Abacus Group
3338 Carlyle Terrace
Lafayette, CA 94549

Telephone: 925-284-7186, FAX: 925-283-5621
E-mail: ccdsexec@email.msn.com

To pay by credit card please fill out the information below and FAX to: 925-283-5621


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Signature _____________________________________  Amount _________

The Abacus Group, 3338 Carlyle Terrace, Lafayette, CA 94549
Telephone: ---, FAX: 925 283 5621
E-mail: ccdsexec@email.msn.com Website http://www-lecb.ncifcrf.gov/ESAB/