IASPRR - Membership Form

Enter personal information   Check personal information   Enter professional information   Choose password and submit   Finished

If you would like to join, please answer the questions in this form and submit it to the Secretary, IASPRR.
The field marked with * have to be filled in.

Personal information
Surname (family name)*:
Middle name:
First name (given name)*:
Title (Mr., Mrs., Dr. Prof., etc.):
Postal code*:
State or Province:
Telephone number:
Fax number:
Membership and payment
Type of membership (select one): Individual member (Annual fee: €30.- )
Student member (Annual fee: €15.- )
Corporate member (Annual fee: €100.- )
Lifetime membership (€300.- )
Prepayment: I want to pay the fee for years in advance.

When registering for the first time as a member, the payment for a 2-year membership is required to simplify the database record keeping.

Do not share my data with other members.
(Your data will not yet be submitted.)