| Please print this form and fill in all information requested, particularly email address. Enclose your membership dues and your business card. |
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| NAME (print) |
_________________________________________________________________ |
| Affiliation |
_________________________________________________________________ |
| Full mailing address |
_________________________________________________________________ |
| Email address (write clearly) |
_________________________________________________________________ |
| Telephone work : |
_____________ |
fax: |
_______________ |
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| Telephone home |
_____________ |
cell: |
_______________ |
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| I wish to sponsor |
_____________ |
Caribbean member(s) unable to afford membership (x $20) |
| Enclosed check or money order for $ |
_____________ |
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Mail this form and membership dues to: |
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Rosemarie Gnam, SCSCB
4201 Wilson Blvd, Suite 110-174
Arlington, VA 22203, USA.
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| Annual dues are US$20.00 for individuals, US$120 for U.S. and European-based institutions and US$50 for Caribbean-based institutions. |
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| Life Memberships are also available for US$300. This fee may be paid in three annual installments – contact the Treasurer for further details |
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| Dues can be paid with a US check made payable to the Society for the Conservation and Study of Caribbean Birds OR with a postal money order made payable to Rosemarie Gnam, SCSCB. |
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