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American Chemical Society
1995 Membership Application
1155 Sixteenth Street, NW, Washington, DC 20036
An Invitation T h e American Chemical Society, t h e w o r l d ' s largest scientific organization, invites you to join in m e m b e r s h i p w i t h m o r e t h a n 150,000 o t h e r chemists a n d scientists in allied fields. We h o p e this application will p r o v i d e t h e o p p o r t u n i t y for you to take advantage of t h e m a n y benefits ACS offers to its m e m b e r s . Please type or
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Previous Membership: I—I I have I I have n o t previously b e e n a member. If y o u r s p o u s e is a m e m b e r , please give his/her n a m e a n d m e m b e r s h i p n u m b e r
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Demographic Information T h e following v o l u n t a r y i n f o r m a t i o n is collected for d e m o g r a p h i c p u r p o s e s only. Individual confidentiality will b e m a i n t a i n e d a l t h o u g h statistical data may b e p u b l i s h e d in t h e aggregate. I n f o r m a t i o n p r o v i d e d will n o t b e used o r c o n s i d e r e d in c o n n e c t i o n w i t h any d e c i s i o n regarding membership. Racial-ethnic origin: L J W h i t e (Caucasian) π
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This space for use of ADMISSIONS COMMITTEE
Local Section/Division Commission Claim
0715H
1
4WF2-95
Courses Completed NOT REQUIRED of those with a degree in chemistry or a closely related
science.
Please list completed courses (by title) in the chemical sciences. (Attach separate sheet or transcript if more space is needed). Quarter hour credits should be multiplied by two-thirds. If school did not use a credit hour system, please estimate credits on basis of 15 lecture clock hours or 45 laboratory clock hours as equivalent to one semester hour credit. Course Title
Semester Hours
Semester Hours
Course Title
Semester Hours
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Dues/Subscriptions/Divisions
Π MOST DIVISIONS OFFER FREE MEMBERSHIP TO NEW MEMBERS FOR ONE YEAR! Check here if you wish complete information. There are four start dates for membership: 1 January, 1 April, 1 July, and 1 October. We are anxious to begin your membership as soon as possible and will therefore enroll you immediately upon approval of your application by the ACS Admissions Committee. Dues for 1995 are $96.00. Your membership will begin at the nearest quarter and you will be billed accordingly. Those entering 1 October will be billed for the three remaining months of the year plus the full dues for the following year (or 15 months dues) or the new member may pay for the final three months of the current year only. Former members w h o 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. Six Month Dues Waiver for New Graduates—A person graduating with a bachelor's degree in a chemical science may apply for member ship, and receive a half-year waiver of member dues to begin during any quarter up to one year from the date of graduation. National Affiliation — National Affiliates pay three-quarters dues (i.e., $72.00) and likewise will receive a prorated bill based on the quarter National Affiliation begins. Husband/Wife Dues — If you are the spouse of a member receiving C&EN, a portion of your dues that is allotted for C&ENmay be deducted. If you would like to request the deduction, please provide the name of your spouse and his/her membership number on page one. This savings will be reflected on your dues bill. LOW MEMBER SUBSCRIPTION RATES. If you wish to subscribe to any ACS publications, please list them below.
Remember, send no money now.
IUPAC Affiliation
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 Affiliate dues for ACS members residing in the U.S. are $2900 and include a subscription to Chemistry Internationa magazine. Q I U P A C Affiliation $2900 (U.S. members only).
Nomination Nomination by t w o ACS members is required by ACS Bylaws. If this presents difficulty, please call the Admissions Office at 2 0 2 / 8 7 2 - 4 5 6 7 for assistance. NOTE: Such nomination is not necessary for former members. Student affiliation does not constitute membership. We recommend
for membership (NAME OF
in the American
Chemical
Society.
APPLICANT)
ACS Member:
. (SIGNATURE)
(PRINTED
NAME)
(SIGNATURE)
(PRINTED
NAME)
ACS Member:
Agreement 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. (SIGNATURE OF APPLICANT)
2
(DATE)
