ASSOCIATE MEMBERSHIP

Associate members are individuals who, although they are not research scientists, have made contributions in the area of alcohol research, alcoholism prevention and treatment. These individuals will not have privileges of voting nor shall they hold office but they may attend annual meetings at the member's rate. Their dues shall be the same as regular members with the option of receiving the journal, ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH, at the member's rate.

Currently, Associate member dues are $40. The optional subscription to the Journal is an additional $110 ($150 for members outside of North America).

All fields are required. In the tables, all fields in the first row are required. If an entry is not applicable, enter NONE.

First Name: Middle Name: Last Name: Degree(s):
Affiliation:
Work Address:
City: State: Zip/Postal Code:
Country:
Telephone Number: Fax Number:
Email Address:
Confirm Email Address:
Primary Discipline: (Please be brief, 1-3 words)

(THE ABOVE INFORMATION WILL BE USED IN THE RSA MEMBERS DIRECTORY)

EDUCATION:

Institutions Degree Date


POSITIONS HELD:
Location Position Date

What is your primary discipline?

What is your chief interest in alcoholism research?

Professional services related to alcoholism:

Membership in professional and scientific societies:


If accepted, I WILL WILL NOT subscribe to the journal.

Cut/Paste your 3-page limit Biosketch into this box - please edit your Biosketch as is necessary to illustrate
the fact that your are currently engaged in alcohol research e.g., grant funding, upcoming conference presentations,
and/or recent papers/abstracts etc.
Entries over 18,500 characters, including spaces, may be truncated.
Characters left: <-- If this is negative you are OVER the limit!

Please review all the above carefully before pressing the Submit button.
All fields are required. In the tables, all fields in the first row are required. If an entry is not applicable, enter NONE.

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