ACS Division of Environmental Chemistry
Membership Form

Invitation to Join ACS Toxicology Division

Membership in the Division of Environmental Chemistry is open to all members and National Affiliates of the American Chemical Society upon request to the Secretary of the Division and payment of dues. A person who is not a member or National Affiliate but wishes to participate in the activities of the Division may become a Division Affiliate provided that person is not a chemist or chemical engineer residing in the United States, is approved by the Division's Executive Committee, and pays Division Membership dues. All people who live in other countries (and who are not U.S. chemists or chemical engineers) may join the Division.

Instructions

To Join the Division simply fill in the Division Membership Form below,

and send it with your payment (U.S. funds only) to Ruth Hathaway at:

Ruth Hathaway
Hathaway Consulting
1810 Georgia Street
Cape Girardeau, MO 63701-3817
Phone: 573-334-3827
FAX: 573-334-2551
Email: ruthhathaway@msn.com

Cost

• Member of the American Chemical Society: $15.00
• Student Member: $10.00
• Division Affiliate (not a U.S. chemist or chemical engineer or from another country): $20.00 + $4.00 postage outside the USA

Membership Form

 First Name:

Last Name:

Company:

Mailing Address:

City:

State/Providence:

ZIP Code:

Country:

Telephone:

Fax:

Email (very important):

Payment Form: (specify check or credit card):

(if a credit card is used include the Exact Name on the Card, Card Number, Expiration Date):

Three Ways to Send Payment and the Membership Form

• You may copy the form and email it with your Master Card or Visa Card number if you are comfortable sending credit card information using a non-secure email site. If you have questions please send an email to Ruth Hathaway: ruthhathaway@msn.com.  To copy the form place your cursor at the beginning of the form, drag it to the bottom of the form highlighting the area to be copied, then go to Edit on your tool bar and select Copy. Next click on the email address ruthhathaway@msn.com and move the cursor to the text area of the email form. Next go to Edit on your tool bar and select Paste. This will paste the form into your email form where you may fill in the appropriate information before clicking on Send to send it to Ruth Hathaway.
• You may copy and print the form, complete it, and fax it with your Master Card or Visa Card number to Ruth Hathaway at +573-334-2551.
• You may copy and print the form, complete it, and mail it with your check (using U.S. Funds) to Ruth Hathaway at the above mailing address.