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{\large\bf INTERNATIONAL SOCIETY ON GENERAL RELATIVITY AND GRAVITATION\\
Membership Form: Individual Membership Only}
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\noindent When completed, return this form to Professor M A H MacCallum,
Secretary, 
International Society on General Relativity and Gravitation, School of
Mathematical Sciences, Queen Mary, University of London, Mile End Road,
London E1 4NS, U.K. (or email to M.A.H.MacCallum@qmul.ac.uk).\\
\rule{6in}{.01in}\\
{\bf Please type, or write in block letters}\\
Title:\\
Name:\\
Department and Institution:\\[12pt]
Address for correspondence:\\[24pt]
Phone:\\
Fax:\\
Email:\\
I will accept Society communications via email:\hspace*{10pt} Yes/No \\
\rule{6in}{.01in}\\
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{\bf For new members only}\\[3pt]
Please provide ONE of the following: (i) the references for three
scientific publications published in refereed journals; (ii) the names
and signatures of two existing GRG Society members willing to sponsor
you; or (iii) if you are presently a student or have obtained your
Ph.D. degree within the past year, a brief letter of support from your
advisor.
\\[3pt]
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\noindent\rule{6in}{.01in}\\
\noindent{\bf For all members}\\
I wish to join/renew membership of the International Society on G.R.G. and
am remitting a fee of \rule{1in}{.005in} USD/CHF/Euros/GBP to cover life
membership/the years   \rule{1in}{.005in}\\[8pt]
Payment will be made by (mark the applicable one):\\
\begin{tabular}{llll}
  Bank transfer to Bern & $\Box$&   &  \\
   Cheque herewith & $\Box$ &        Cheque mailed to Penn State&
   $\Box$\\
   Visa credit card (details below)&$\Box$&
   Mastercard credit card (details below)&$\Box$\\
\end{tabular}\\[8pt]
Card number \rule{2.4in}{0.005in} with checksum
number\rule{1in}{0.005in} \\[3pt]
in the name of \rule{3in}{0.005in} expiring \rule{1.2in}{0.005in}\\[8pt]
I require a receipt for this payment: Yes/No\\[10pt]
Signature \hspace*{2in}         Place and date:
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