Address:________________________________________________________________

Postal/Zip Code: & Country:________________________________________________

Telephone # (Country Code & Area Code):____________________________________

Fax:_______________________________ E-mail:_______________________________

Professional Profile: Academic [ ] Research [ ] Management [ ] Other [ ]

AEHMS Anuual Membership Fees

1. Regular membership with Journal......................U.S. $60.00 [ ] $110.00 [ ] FOR 2 YEARS

Method of Payment:

A. Credit Card: MasterCard: [ ] Visa: [ ]

Card Number:_____________________________________________________________

Expiry Date: ______________________________________________________________

Signature: _______________________________________________________________

B. Cheque: Bank draft or money order in U.S. funds (payable to Aquatic Ecosystems Health and Management Society)

Please provide, briefly, on a separate sheet:

1) Academic Information/Research Background

2) Please suggest other scientists as potential members
(include their address, phone, FAX, etc., and use an additional page for these details).

Signature:__________________________________________________ Date: _________

Return to: AEHMS, P. O. Box 85388, Brant Plaza Postal Outlet,
Burlington, Ontario, Canada, L7R 4K5. Fax: (905) 634-3516
E-mail: ifatima@cogeco.ca
aehms@yahoo.ca
www.aehms.org