INTERNATIONAL SOCIETY FOR CLINICAL BIOSTATISTICS
2017 Membership Subscription
Surname: / First name:
Title (Prof/Dr/etc): / Post held:
Institute/Company:
Address:
Post code and country:
Phone No.: / E-mail:
Fax No.: / Please provide your email address in order to log on to the Members’ Area of ISCB’s website; it may be used to send you the electronic ISCB News in the future, and is needed for voting.
Member No.:
Early registration
Jan.-April / Late registration
May-Dec. / ISCB membership to 31 December 2017:
SUBSRCIPTION: / EUR 40 / EUR 60 / Regular members
(please tick one only) /  EUR 10 / EUR 30 / Student Members (applicable to undergraduate or postgraduate -Masters or PhD- students) (students should provide a letter from their supervisor or head of department)
EUR 10 / EUR 30 / Retired members
EUR 10 / EUR 30 / DC membersDeveloping Country
EUR 5 / EUR 25 / DC student membersDeveloping Country
Have you previously been a member of ISCB?YesNo
New members: Please send this Membership Subscription form to .
Your details will be uploaded to the Members’ Area of ISCB’s website,
and you will be notified when you can follow the procedure below.
Current members: Please log on to the Members’ Area with your e-mail address.
PAYMENT IS MADE BY: / On-line payment
  • Go toThe Members’ Area:
  • Apply for your password by clicking on “forgotten password”
  • Type your email address and click on “Send password”You receive your password by email
  • Log on to the Members’ Area using your e-mail address and your password.
  • Click Renew membership on the left-hand bar –
accept conditions – accept order – select payment method – Maestro / Master Card / Visa / Visa Electron / JCB - and complete payment. You will receive an email from us confirming that you have renewed your membership once your payment is completed.
Your address details and membership category are already entered into the system. In the Members’ Area you can edit your Profile Settings, except your e-mail address. Please contact if you wish to change your e-mail address.
Please note that ISCB’s online payment facility is a secured system; your credit card information cannot be accessed or used for any other purpose.
PS:Danish VISA/Dankort cards are not supported.
If you wish to pay your membership fee by bank transfer we ask you kindly to contact the Permanent Office for ISCB’s bank account details ().
Please return this form either by e-mail to: / /
or by post to: / ISCB Permanent Office
Bregnerodvej 132
DK-3460 Birkerod
Denmark
Tel: / +45 2682 7970