SEG 45 Final_qx4 - Society of Economic Geologists
SEG 45 Final_qx4 - Society of Economic Geologists
SEG 45 Final_qx4 - Society of Economic Geologists
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
46 <strong>SEG</strong> NEWSLETTER No 63 • OCTOBER 2005<br />
–<br />
DUES ARE PAYABLE IN ADVANCE OF JANUARY 1, 2006<br />
[ ]:<br />
Fellow, Member - Standard US$95.00 � <strong>Society</strong> US$_________<br />
Electronic Membership US$75.00 � <strong>SEG</strong> Foundation General Fund US$_________<br />
E-Membership w/ print Newsletter Hugo T. Dummett Fund US$_________<br />
Additional US$10.00 � Alberto Terrones L. Fund US$_________<br />
Couples 2 nd Membership US$25.00 � Timothy Nutt Fund US$_________<br />
Student Membership US$10.00 � Hugh E. McKinstry Fund US$_________<br />
Student Membership w/Print Journal US$50.00 � Hickok-RadfordFund US$_________<br />
**Senior Fellows requesting printed journal US$50.00 � <strong>SEG</strong> Canada Foundation – please refer to page 47<br />
**[Senior Fellows not requesting the journal do not pay dues; to retain membership, please return completed form.]<br />
Honorary and Life Fellows, Post-1972 Lindgren Awardees<br />
[Exempt members must indicate if they wish to receive the journal, ] Initial here: _______<br />
An explanation <strong>of</strong> benefits by membership category for 2006 is detailed on page 47.<br />
to the <strong>Society</strong> (<strong>SEG</strong>) and/or the <strong>SEG</strong> Foundation may be included with the dues payment. Income from invested contributionsis<br />
used to support pr<strong>of</strong>essional activities <strong>of</strong> both organizations. The <strong>SEG</strong> and the <strong>SEG</strong> Foundation are tax-exempt501(c)(3) corporations under U.S.<br />
IRS code. The <strong>SEG</strong> Canada Foundation is a charitable organization registered with the Canada Customs and Revenue Agency.<br />
<strong>SEG</strong> Member Number (from mailing label) ____________ Date:______________________<br />
[circle one]<br />
Mr / Ms / Dr Last Name___________________________________ First Name________________ M. I.____________<br />
�<br />
Company/Institution__________________________________________________________________________________<br />
�<br />
Mailing Address_____________________________________________________________________________________<br />
__________________________________________________________________________________________________<br />
City________________________State/Province_____________Postal Code_____________Country_________________<br />
Phone____________/____________/__________________ Fax____________/____________/__________________<br />
E-mail_____________________________________________________________________________________________<br />
may be made by check (drawn on U.S. bank), money order or credit card in U.S. dollars.<br />
Make checks payable to: <strong>Society</strong> <strong>of</strong> <strong>Economic</strong> <strong>Geologists</strong><br />
American Express � Visa � Mastercard � Discover �<br />
Card No. Expiration Date _______________<br />
Signature________________________________________________________________________<br />
Mail payment to: <strong>Society</strong> <strong>of</strong> <strong>Economic</strong> <strong>Geologists</strong>, Inc.<br />
7811 Shaffer Parkway<br />
Littleton, CO 80127-3732 U.S.A.<br />
FAX: 1.720.981.7874<br />
For <strong>of</strong>fice use only<br />
DB________________________<br />
JRNL______________________<br />
NSL ______________________<br />
__________________________