1. GENERAL INFORMATION
Title: _____ (Dr., Mr., Ms., etc.)
First Name: ___________________ Middle: ___ Last Name: ______________________
Organization: ____________________________________________________________
Mailing Address: _________________________________________________________
_________________________________________________________________
_________________________________________ City: ___________________
Province/State: ____________ Postal Code/Zip: _____________ Country:
_____________
Phone: _____________ Fax: ______________ E-Mail: ____________________________
2. MEMBER TYPE (check one)
__ Regular Member - $40.00
__ Regular Student Member (if a full-time university student) - $20.00
__ Associate Member (if a member of one of the following societies) - $20.00
Circle One: CAP CIG CMOS GAC SQG CGRG (click here to see
definitions)
__ Associate Student Member (student and member of one of the
following) - $10.00
Circle One: CAP CIG CMOS GAC SQG CGRG (click here to see
definitions)
Members of GAC Geophysics Division automatically become members of CGU.
Members of CAP may pay their CGU dues to CAP, and let CAP transfer the payment
to CGU.
3. PRIMARY SECTION AFFILIATION (check one)
General___ Hydrology___ Geodesy___ Biogeosiences___ Solid Earth___
4. SECONDARY SECTION AFFILIATION (optional)
Hydrology___ Geodesy___ Biogeosiences___ Solid Earth___
5. NEWSLETTER ELEMENTS (check one)
I wish to receive hardcopies of Elements by mail (no extra cost) ___
I do not wish to receive hardcopies of Elements ___
6. PAYMENT INCLUDED: $______ (in Canadian dollars)
Please include cheque or money order (Payable to the Canadian Geophysical Union).
If you would like to use a credit card, please use the online registration system.
http://www.cgu-ugc.ca/membership/how.html
MAIL TO:
CGU Secretariat, University of Calgary, Dept. of Geoscience
2500 University Drive NW, Calgary, Alberta T2N 1N4 CANADA
Fax: (403) 284-0074