Associate Member Registration

PROFESSIONAL – individuals who use this work in their regular job ($35.00 US)ORGANIZATIONAL – groups who want to maintain a collective connection with this work ($50.00 US)STRUCTURAL – groups or individuals who support the underlying foundation this work is built upon ($100.00 US)

Your Name (first, last) OR Organization Name

Centre or Organization Representative Name

Your Email

Street Address

City

Province/State/County

Country

Zip or Postal Code

Telephone Number

Please send me a registration form I can print and I will enclose it with a check in USD drawn on a US bank for the membership category I have selected.I am returning my completed registration form electronically and will pay the membership fee noted via Paypal to iee1@aol.com, inserting “membership fee” in the Paypal record.I am returning my completed registration form electronically and will pay via a credit card through the shopping cart here.I am returning this registration form electronically. Please notify me if there is an Affiliate in my area that can accept payment in my currency.

My Role as an Associate (and other notes)

Δ