Welcome to ISME

Application Form

Welcome to ISME!

We are happy to have you as an ISME member!

Please tick appropriate brackets, fill in the blanks, and send to ISME Secretariat by post together with your payment. If you are making your payment by credit card, you can return this form by facsimile. After receiving your form and payment, we will send you membership card and latest issue of ISME Newsletter.

Thank you for your support for conserving mangrove ecosystems!!

[ ] New Member [ ] Renewal Member
[ ] Individual member (renewable annually) [ ] Life member (applicable to individual members only)
[ ] Institutional member (renewable annually)
NAME
Title: [ ] Mr. [ ] Ms. [ ] Dr. [ ] Prof. Sex: [ ] Male [ ] Female
Given name: / Middle name: / Family name:
ADDRESS
Mailing address:
Country:
Telephone: / Facsimile: / E-mail:
ISME disseminates Newsletter in PDF through E-mail. Please help us to save paper and postage by ticking the box below.
[ ] would like to receive Newsletter in PDF through E-mail.
PAYMENT *Please note we can charge only in Japanese Yen (JPY).
[ ] Individual Membership:
[ ]Annual membership:
JPY2,000 (approx. equiv. to US$20) x _____ years = JPY
(specify the year(s): ______)
[ ] Life membership: JPY20,000 (approx. equiv to US$200)
[ ] Institutional Membership:
[ ] JPY25,000 (approx. equiv. to US$250) x _____ years = JPY
(specify the year(s): ______)
[ ] Donation: JPY
Total amount of payment: JPY
METHOD OF PAYMENT
[ ] International Postal Money Order (Please make it payable to International Society for Mangrove Ecosystems)
[ ] Credit card ([ ]Visa; [ ]MasterCard)
Card holder’s name:
Credit card number: / Expiration date: month/year
8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 8 / 88/88
Signature: / Date:

Please do not e-mail your card information.

Please mail or fax this form to:

ISME Secretariat

c/o Faculty of Agric.,Univ.of the Ryukyus

Nishihara, Okinawa, 903-0129 Japan

Facsimile: (+81)98-895-6602

Thank you.

International Society for Mangrove Ecosystems