1998 MEMBERSHIP APPLICATION - C&EN Global ... - ACS Publications

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M E R I C A N

CH E M I C A L

S O C I E T Y

1155 SIXTEENTH STREET, NW · WASHINGTON, DC 2 0 0 3 6

1998 MEMBERSHIP APPLICATION PROFESSIONAL EXPERIENCE

AN INVITATION The American Chemical Society, the world's largest scientific organization, invites you to join in membership with more than 155,000 other chemists, chemical engineers, chemical technicians, and scientists in allied fields. Among many exclusive member benefits is an automatic, personal subscription to Chemical & Engineering News.

• Mr.

• Mrs.



Dr.



Miss

• Ms.

Job Title. Employer Employer City, State, Zip_

Inclusive Dates/Employment (MO./YR.).

Family Name Nature of Business:

First Name



Manufacturer



Academic



Government



Other (Please Specify)

Middle Name Time Spent on Chemical Work Mailing Address:



Home



Work

Work Functions

DEMOGRAPHIC INFORMATION

Fax

The following voluntary information is collected for demographic purposes only. Individual confidentiality will be maintained, although statistical data may be published in the aggregate. Information provided will not be used or considered in connection with any decision regarding membership.

E-mail

Racial-ethnic origin (please check one only):

Telephone:

Home. (Area Code) Office (Area Code)



White (Caucasian)





Black or African American



Native Hawaiian or Pacific Islander

I have previously been a student affiliate.



Hispanic



Other

If your spouse is a member, please give his/her membership



Asian

number

Date of Birth



I have previously been an ACS member.

Q

American Indian or Alaskan Native

Sex:



F

• M

ACADEMIC TRAINING Name of College or University (Including current enrollment)

City and State

ACS Approved School: •

Yes

Curriculum Major

Title of Degree(s) Received or Expected B.S., M.S., Ph.D.

Date Degree Received or Expected

PLEASE NOTE: If you have less than a B.S. degree in chemistry, chemical engineering, or a chemistry-centered science but have significant achievement in the chemical sciences, you may be required to fill out a supplementary information form.

• No

For more information: CALL (800) 227-5558 or (202) 872-4568 TDD (202) 872-4434 FAX (202) 872-6337 E-MAIL [email protected] ALL APPLICANTS MUST COMPLETE THE REVERSE SIDE OF THIS FORM

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Office Use Only ASD _ PNI .TEC_

This space for use of ADMISSIONS COMMITTEE 3756K

Local Section/Division Commission Claim

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ΪΤΠΤ DUES/SUBSCRIPTIONS/DI

• IUPAC Affiliation $29.00 (U.S. members only). The International Union of Pure and Applied Chemistry (IUPAC) offers individual affiliation to members of national chemical societies. Recognized by all the sciences and by the national level academies of science as the international representative body for chemistry, IUPAC is the authority on chemical nomenclature, terminology, symbols, atomic weights, and related topics. IUPAC Affiliates dues for ACS members residing in the U.S. are $29.00 and include a subscription to Chemistry International magazine.

Dues are prorated on a quarterly basis. Your membership will begin during the nearest quarter. Former members who did not resign will be assessed a $10.00 reinstatement fee. Please send no money now. Student Discount — A member who is a student, undergraduate or graduate, majoring in a chemical science or a related academic discipline, shall be entitled to a discount of one-half of the membership dues so long as the student certifies registration for at least six credit hours as an undergraduate or is doing full-time graduate work.

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Six-Month Dues Waiver for New Graduates —A person graduating with a bachelor's degree in a chemical science may apply for membership within one year from the date of graduation to receive a half-year waiver of member dues.

Nomination by two ACS members is required by ACS Bylaws. If this presents difficulty, please call the Admissions Office at (202) 872-4568 for assistance. NOTE: Such nomination is not necessary for former members. Student affiliation does not constitute membership.

National Affiliation — National Affiliates pay three-quarters dues and likewise will receive a prorated bill based on the quarter National Affiliation begins.

We recommend for membership in the American Chemical Society: Name of Applicant

Husband/Wife Dues — If you are the spouse of a member receiving Chemical & Engineering News, you may deduct a portion of your dues allotted for C&EN. Please request this deduction on your dues bill.

ACS Member: Signature Printed Name ACS Member: Signature

MEMBER CATEGORIES

1998 DUES Printed Name

Member

$102.00

Student Member

$51.00

AGREEMENT

National Affiliate

$76.50

I attest to the accuracy of information on the application. I agree to restrict for my own personal use all publications to which I subscribe at member rates. I understand that membership dues are payable annually unless my signed resignation is received by the Executive Director before January 1 of the year for which my resignation is to take effect.

MEMBERSHIP START DATES January 1

PRORATED DUES 100% 1998 dues

April 1

75% 1998 dues

Julyl

50% 1998 dues

October 1

25% 1998 dues +

Signature of Applicant

100% 1999 dues

The mission of the American Chemical Society is to encourage in the broadest and most liberal manner the advancement of the chemical enterprise and its practitioners.

New ACS members are eligible for FREE membership in any one of 32 discipline-specific technical divisions.

Call 1-800-227-5558 for details. ACS members save substantially on the nonmember subscription rates for ACS journals and magazines.

For more information, call 1-800-333-9511 (U.S. only) or 614-447-3776, or access http://pubs.acs.org. 2