African Physical Society Membership Application

 
Section 1: Member Information
Salutation*
  
First Name*
  
Middle Initials
  
Last Name*
  
Institution/Company*
  
Department*
  
Position Title*
  
Office Address*
  
Office Mail Code
  
City*
  
State/Province*
  
Postal Code*
  
Country*
  
Work Phone
  
Mobile Phone
  
E-mail*
  
E-mail 2*
  
Web Site
  
Web Site 2
  
DOB*
  
Gender*
  
User Name*
  
Password*
confirm password 		 
 
Section 2: Educational History
Enter your Education History*
School: Degree:
Major: Year Graduated:
       
School: Degree:
Major: Year Graduated:
       
School: Degree:
Major: Year Graduated:
       
School: Degree:
Major: Year Graduated:
       
 
Section 3: Career History
Enter your Career History
Company Information:
Name:
Description:
       
Position Information:
Title:
Description:
Start Date: End Date:
Company Information:
Name:
Description:
       
Position Information:
Title:
Description:
Start Date: End Date:
 
Section 4: Subscribe to Technical Groups
*
Acoustics (ACOU)
Astronomy and Astrophysics (ASTRO)
Atomic, Molecular and Optical Physics (AMO)
Chemical and Biological Physics (CBP)
Condensed Matter and Materials Physics (CMMP)
Cosmology, Gravitation and Relativity (CGR)
Earth and Planetary Systems Science (EPSS)
Fluid and Plasma Physics (FPP)
Health Physics (HEA)
History, Policy and Education (HPE)
Mathematical and Computational Physics (MCP)
Medical Physics (MED)
Nuclear and Particle Physics (NPP)
Photonics and Optics (POP)
Physics Education Research (PER)
Secondary School Teaching (SST)
Technology Transfer, Business Development and Entrepreneurism (TBE)
 
 
Section 5: Membership Type
Membership Type*
 $25.00 - Senior Professor/Researcher:
$10.00 - Secondary School Teacher:
$5.00 - Post-doctoral Research Associate:
$5.00 - Graduate Student (includes AAPS Membership):
$5.00 - Undergraduate Student (includes AAPS Membership):
 
 
Section 6: Dues Payment
Payment Method*
    Cheque
    Send invoice
 
 

For security reasons,

type in the code below:

Play Sound