EWRA Membership - becoming a member

 


Becoming a member

To become a member, please fill in the registration form shown below and send it (via Internet) to EWRA.

Please, use only English (U.S.) character set - there is no support for local languages!!

Information of acceptance will be sent to the applicant by E-mail.

Name:       

Surname:   

Gender: M F

Student: Yes No
Title:         

Current occupation:
*Affiliation:

*Area of interest (not more than 3 major subjects)

            *1.:

            *2.:

            *3.:


Address

Street & Number:   

City:         

Postal code: 

Country:    
Telephone: 

Fax:           

E-mail:       

*Do you agree to have your name on lists that might be publicized: Yes No

*Comment / Additional information: 
Note: fields marked with * are not obligatory.