MEMBERSHIP RENEWAL FORM
Renewal Form for Existing Members
Membership Number (Please contact the membership secretary if you do not have this number)
*
Your Name:
*
Your Email:
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Please provide the rest of the information on this page only if it has changed from your renewal form!!!
Address Line 1:
Address Line 2:
City
Province / State
Country
Postal Code
Home Phone Area Code
Home Phone Number
Work Phone Area Code
Work Phone Number
Fax Number
Occupation
Employer
Main Expertise
Acidification
Aerobiology
Agriculture
Agronomy
Air Quality
Animal Ecology
Animal Physiology
Aquaculture
Aquatic Ecology
Arctic Ecology
Animal Behavior
Bentic Ecology/Invertebrates
Bioacoustics/Telemetry
Biochemistry
Biometrics/Biostatistics/Design
Botany
Chemical Ecology/Chemistry
Communication/Education
Conservation
Contaminated Soils
Disturbance Ecology
Ecological Risk Assessment
Entomology
Environmental Audit
Environmental Engineering
Environmental Impact Assessment
Environmental Law
Environmental Monitoring
Planning/Policy/Regulations
Fish Ecology
Fish Entrainment
Fish Physiology
Fish Taxonomy
Forest Ecology/Management/Silviculture
Freshwater Ecology
Genetics
Geobotany
GIS
Habitat Assessment/Restoration
Habitat Conservation
Herpetology
Hydroelectric Impacts
Hydrogeology
Ichthyology
Immunology
Instream Flow Assessments
Integrated Resource Management
Invertebrate Ecology
Landscape Dynamics
Land Use Planning
Larval Fish
Lichen Ecology
Limnology
Marine Biology/Ecology
Microbiology
Mine Reclamation
Modelling
Nematology
Occupational Health & Safety
Ornithology
Paleo-Ecology
Parasitology
Pest Management
Pesticides/Toxins
Phytoplankton/Phycology
Plant Ecology
Pollution
Predator Control
Range Management
Rare & Endangered Species
Riparian Habitat
Software Development
Soil Science
Solid Waste Management
Stream Biology
Terrestrial Ecology
Toxicology/Ecotoxicology
Ungulate Ecology
Veterinary Medicine
Wastewater Treatment
Water Quality
Water Resource Management
Wetland Ecology
Wildlife Disease
Wildlife Ecology
Zoology
Zooplankton
Other
Membership Level (See Membership Page for Requirements)
Regular
Associate
Student
Library / International Member
Student Number and Institution (if applicable)
Would you like the email address you provided added to the listserv?
Yes, I'd like to stay in touch!
No, thanks.
Would you prefer an electronic copy of the newsletter?
Yes, let's save paper and money!
No, I would prefer a hard copy.
Date
Electronic Signature (Please type your name)
Additional Comments
I would like to help....
Newsletter - write an article
Newsletter - guest editor
Newsletter / Website - gather advertising
Issues - will work on issues committees
Issues - will work on specific issues
Conference - will help plan/run conference
Executive - will stand for a position on the National or Chapter Executive
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Required Information
If you have your membership number, please provide ONLY YOUR NAME AND EMAIL unless the information has changed from the renewal form sent to you.
If you do not have your membership number, please contact the Membersip Secretary BEFORE filling out this form.