Member Sponsorship Program

MEMBER SPONSORSHIP PROGRAM
Your
Name: ______ASM ID#: ______
(Please Print)

Part A- Specific Sponsorship

I would like to sponsor: ______
(Please Print Name of Scientist (s))

Please check one box below:

 I have enclosed a completed 2003 membership application for my candidate(s) OR

 I have forwarded an application to the candidate(s) to be completed and returned to ASM OR

 Please send an application to my candidate(s) at the following address(es):

______

______

______

______

 Please indicate that ASM may acknowledge your contribution in ASM News by checking here.

OR

Part B- General Sponsorship

IIf you want to sponsor a member(s) and do not know a candidate, you may earmark your contribution for a particular part of the world, a specific member category and indicate whether you want your sponsorship to be reserved for a minority candidate.

 YES! I want to sponsor an eligible scientist(s) from the following region(s) in the following member categories:

US /  Full /  Transitional /  Student /  Minority / Minimum contribution for each member type:
Full $49
Transitional $29
Student $15
Contributions are appreciated in any amount. Rate information is provided to indicate how many memberships your donation will sponsor.
Canada /  Full /  Transitional /  Student
Latin America /  Full /  Transitional /  Student
Europe /  Full /  Transitional /  Student
Africa /  Full /  Transitional /  Student
Pacific Rim /  Full /  Transitional /  Student / Please note that these rates do not include the cost of journal subscription(s). In order to maximize the number of scientists who receive sponsorship, only electronic journals may be received by sponsored members. Please include additional funds if you would like your recipient to receive a journal subscription(s). The maximum amount to be applied to a sponsored member's journal subscription is $190.
Middle East /  Full /  Transitional /  Student
Other: ______
(Specify Country)

 Please indicate that ASM may acknowledge your contribution in ASM News by checking here.

Payment Information

Memberships will be initiated for the 2003 member year beginning January 1st. All contributions must be received in US Dollars. Checks must be made payable in US Dollars drawn off a bank located in the Continental United States. Your payment must accompany this form.

Enclosed is my payment of $______foro Full o Transitional o Student o Any Type
(amount) (Check appropriate category)

membership(s) in the American Society for Microbiology: My check is enclosed.

 Please charge my credit card:

Name (as it appears on card): ______

___ American Express ___ Visa ___ Mastercard ___ Eurocard /__/__/__/__/__/__/__/__/__/__/__/__/__/__/__/__ Exp Date:______

For more information about this program, please contact Jennifer Mercurio, telephone (202) 942-9289 or via email at .

Please return this form together with your payment to ASM, 1752 N Street, NW, Washington, DC 20036 Attn: Membership.

Thank you for your support of the microbiological sciences!