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Membership application Print
Please print out this form, fill it out and send or fax it to:

IEES, c/o Patrick Krummenacher, ecovia, Hackenrüti 8, CH-6110 Wolhusen , Switzerland
Fax +41-41 492 50 99; email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

(please check)
Mr. O Mrs. O Ms. O
Title
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First Name
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Family Name
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Private Adress
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Postal Code, City
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Country
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Phone
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Fax
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Email
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Membership fees
(please check appropriate circle)
---ordinary members---
O US$90* if paid with credit card or cash
---ordinary members---
O US$40* if not subscribed to journal Ecological Engineering
---low salary countries---
O US$45* if paid with credit card or cash
---low salary countries---
O US$10* if not subscribed to journal Ecological Engineering
---students---
O US$50* copy of valid student ID is required
---students---
O US$10* if not subscribed to journal Ecological Engineering
  * If paid by check: plus US$5
Note
The journal can only be subscribed for whole calendar years. Please indicate when you want your membership to begin:

Year:______________ 

   
Method of payment
O Cash
  O Direct bank transfer:
   Banc Account: Valiant Bank, CH-6110 Wolhusen,
   SWIFT/BIC-Nr.: VABE CH22;
   IBAN-Nr.: CH26 0630 0016 1853 8551 0;
   Account number: 16 1.853.855.10
   Account-holder: IEES, c/o Bahnhofstrasse 2, CH-6110 Wolhusen
 
O I enclose a check (plus US$5 per year)
  O please charge membership fee to my credit card
   o American Express
   o Mastercard/Eurocard
   o Visa
Card Nr.
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Cardholder's Name
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Expiration Date
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CVC2/CVV2 (last 3 digits in signature field)
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Yes, I wish to become a member of IEES. I accept the articles of the IEES as approved by the participants of the general meeting, August 13, 2006.

Date: _________

Signature: __________________________________________


Form updated June 20, 2014
 
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