ISCA Membership 2004-2005

Application and Renewal Form                                            To be sent to :
                                                                                              ISCA Administrative Secretariat
                                                                                              Emmanuelle FOXONET
                                                                                              "Lous Tourils" - 4, rue des Fauvettes
                                                                                              F-66390 BAIXAS, FRANCE

Title: _______ Last Name: _______________________ First Name: _____________________

First registration to ISCA :     Yes [ ]         No [ ]
If no, ISCA member n° : _________

Day of Birth [optional] :

Affiliation :
Mailing Address :
Post Code, City :
Country :

Phone [incl. country code] :
Fax :
Email address :
Web Homepage :

MEMBERSHIP FEE (Check one)

[ ] Student …………………....…… 15 Euros
[ ] Full Member …………………… 50 Euros
[ ] Institutional Member ...................200 Euros

NB: Students should include a copy of their student ID card for the current year.

SPEECH COMMUNICATION JOURNAL (optional)

Do NOT pay the subscription fee to ISCA ; you will be billed DIRECTLY by the publisher.

ISCA members benefit from a discounted rate for Speech Communication subscription.
From this year, a 'print plus online' subcription only will be available.
Members will received the 2005 volumes in print, and the online access will enable members to also access the Speech Communication archive dating back to 1995.
Individual, FULL member and STUDENT : paper version + online access: 90 EUR
Institutional Member, 'Print only' subcription: 624 EUR

[ ] paper version + online access (90 EUR)
[ ] paper version only for Institutional Member (624 EUR)

* NB* : In applying for a subscription to Speech Communication at a discount, you guarantee that the subscription is for your personal use, not for a library or institution.

PAYMENT (Check one)

From 2002 on, the Euro (EUR) is the only currency accepted by ISCA.

Amount to be paid _______ Euros

[ ] I want to pay with a cheque made payable in EUR to ISCA

[ ] I want to be billed first ; please send an invoice

[ ] I want to pay with a bank transfer (in this case, contact the )

[ ] I want to pay with a    [ ] VISA       [ ] MASTERCARD        
   
Credit card number : _ _ _ _   _ _ _ _   _ _ _ _   _ _ _ _  Exp. _ _ / _ _  Owner : ____________

[ ] I want to use online membership : please click here for secured payment

ADDITIONAL INFORMATION

[ ] I do not want my name and address to appear in the ISCA annual membership CD Rom.
[ ] I am not happy to receive information about ISCA General Meetings by email.
[ ] I need a written receipt for tax purpose


Date: __________ Signature : ______________________________