The Idaho Academy of Science

Idaho Academy of Science

Membership Enrollment/Renewal and Contribution Form

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This information is used for the membership directory. Check here if you do NOT want to be listed in the membership directory.

* Name:			Pay Meeting Registration Fees Please list below the items you want to include in this payment, i.e., registration ($ amount), dues payment ($ amount), and which meals ($ amount). Also indicate the total amount to be paid, and then click on the Continue button below.
Title/Position:
Discipline:
Institution/Co:
Dept./Division:
* Mailing address:
* City, State, Zip:
Phone:
Fax:
* E-mail address:

Please indicate how you would like to receive the IAS newsletter The Retort. The default option (even if you don't check any of them) is delivery by US Mail. However, if you chose to go "paperless", it reduces both printing and postage expenses. Chose any combination of the options below:

	Paper copies via US Mail
	Send me an e-mail note with a link to download it as a PDF file from the IAS web site (Both high and low resolution copies available)
	Send me an e-mail note with a high resolution PDF file attached (large file, typically 4,500 KB)
	Send me an e-mail note with a low resolution PDF file attached (smaller file, 1,000 KB or smaller)
	or
	Do not send the Retort in any of these forms

Please use the field below to send any additional information to the Academy. Examples: If you want to designate your tax-deductible contribution for a specific use (such as scholarships, gift subscription for a library or school, symposium support, etc.), please provide that information. If you're making a "memorial" contribution, please state that and include the name of the deceased and address (if known) for the Academy to notify the family. All other comments or questions about the Idaho Academy of Science are invited and appreciated.

Check here to request a contribution receipt for your tax-deductible contribution to the Idaho Academy of Science.