INTERNATIONAL ALLELOPATHY SOCIETY MEMBERSHIP RENEWAL

Please type or print clearly.

1. Name:_________________________________________ DATE ____________________

Email address (required for ALL members):___________________________________

Mailing address:

Institution:___________________________________________________________

___________________________________________________________________

Street:_____________________________________________________________

City__________________________________Postal code____________________

State/Province_________________________Country________________________

Tel:______________________FAX:__________________________

E-mail address: ______________________________________________________

Interests (keywords) __________________________________________________

2. Payment: (Membership is paid on a triennial basis. Dues paid now will keep your membership current until the Fourth World Congress on Allelopathy in Wagga Wagga, Australia in August 2005.)

Circle amount which applies:
 

Regular member (Australia, Canada, Japan, New Zealand, South Africa, United States, Western Europe)	$50 U.S.
Regular member (All countries not listed above)	$15 U.S.
Student member (Australia, Canada, Japan, New Zealand, South Africa, United States, Western Europe)	$10 U.S.
Student member (All countries not listed above)	$5 U.S.
Life member (Australia, Canada, Japan, New Zealand, South Africa, United States, Western Europe)	$400 U.S.
Life member (All countries not listed above)	$100 U.S.
Voluntary donation to the Society (indicate amount)	______U.S.

                    TOTAL ENCLOSED_____________U.S.

Checks or money orders should be made payable to the International Allelopathy Society, and should be drawn upon a US Bank, and sent to Dr. Leslie Weston, Department of Horticulture, Cornell University, 49D Plant Science, Ithaca, NY 14853 USA. Email for Leslie Weston: law20@cornell.edu.