ESPERE – Environmental Science Published for Everybody Round the Earth

Membership Application Form

International Scientific Association ESPERE

Please send this form filled and signed via FAX or postal service to:

International Scientific Association ESPERE
Jagiellonian University 
Institute of Geography and Spatial Management
c/o Dr. Anita Bokwa
Ul. Gronostajowa 7
PL 30-387 Krakow
Poland
Fax: +48-12-6645385

Herewith I apply for the membership in the International Scientific Association ESPERE.
I agree with the statutes as inscribed in June 2004 by the court at Cracow and published at the following Internet Address.

http://www.espere.net/Aboutus/statutes.html

I declare, that I belong to one of the two following groups, who can apply for membership:
1)	Persons who have either a scientific education and degree in science or comparable experiences from long term work in the field of Earth sciences and work or have been working for several years in the field of Earth sciences.
2)	Persons, who work as teacher, teacher trainer, pedagogue or in comparable positions in science education (geography, chemistry, physics, biology, etc.)

My personal data:

_________	____________________	___________________	______________
   ( title )		(first name)			(last name)			(e-mail)

_____________	____________________________________________________
   (nationality)			(affiliation / place of employment)

____________________________________________	____________________
   ( address )									(FAX number)

I am aware, that the ESPERE Association may ask for an annual membership fee.

Place,  Date	Signature	to be filled in by the Association’s staff:
Member number:	
		to be filled in by the Association’s staff:
Date of receipt, Signature