STUDENT MEMBERSHIP

RSA Student members are enrolled in under-graduate or graduate programs and are actively engaged in alcohol research. Student members pay reduced annual dues, currently $20, and have the option of subscribing to the journal, ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH, at an additional charge of $60 ($100 for members outside of North America). Student members do not have voting privileges.

DO NOTsend your dues payment until your application has been accepted. At that time you will receive an acceptance letter and a dues notice.

Please note: membership as a student requires a letter of endorsement from the student's research supervisor stating the extent of the student's involvement in and nature of the alcohol research.

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)

Please supply the following information (optional):
Gender: Male Female
Are you a member of an underrepresented minority group or an individual with a disability?
Yes No   If yes, please specify:

EDUCATION:

Institutions Degree Date


POSITIONS HELD:
Location Position Date

Name and position of your research supervisor:
Research supervisor's   Email: & Phone:

What is your current student status?

Include a brief summary (2500 character limit) of your alcohol research project.
Characters left: <-- If this is negative you are OVER the limit!


This application must be accompanied by a letter of endorsement from the student's research supervisor stating
the extent of the student's involvement in and the nature of the alcohol research.

Insert Letter of Endorsement (2500 character limit) from your research supervisor:
Characters left: <-- If this is negative you are OVER the limit!


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.

After the response from the update, save the link for viewing (and editing) your application. You are responsible for the contents of your application.


Please press the submit button
-ONLY ONE TIME-!
Please -WAIT- for the response. Thank you.
Submission processing may take several minutes.