Individual Membership Application Form

    Title (e.g. Dr., Mr., Ms., etc.)
    First Name
    Last Name

    Function (e.g. CEO, Student, etc.)

    Organisation Name

    Street Address

    ZipCode         City        Country

    Telephone
    Cellular Telephone
    Telefax
    Email1
    Email2

I apply for personal membership. The 2003 membership fee amounts 100€  (50€ for students.)