Southern New England Chapter of American Fisheries Society
AFFILIATE MEMBERSHIP APPLICATION

Name: Title:
Affiliation
Address
City: State: Zip/Postal Code
Telephone:
Home:
Work:
Fax:
Cell
E-mail: home      work
Area of Expertise
Member of AFS Yes No
Category of Employer Academia
Federal Government
State Government
Industry
Self
Affiliate Membership Dues ($10 per calendar year)  Select one: Credit Card/Paypal    Check  Prepaid
If you just registered for a SNEC meeting at the Non-Member rate, please select Prepaid since your affiliate dues were included in your meeting registration fee.
Where do you want SNEC E-mail information sent? Personal home address
Employer work address

Please complete form, and submit it. If there are any problems with processing, please contact

    
Ian Conboy, SNEC Treasurer
Northeast Fisheries Science Center
1 Quissett Harbor Road
Woods Hole, MA 02543
Phone: (610) 613-8424
Email: Ian.Conboy@noaa.gov

E-mail: treasurer@snec-fisheries.org

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