IRISH MATHEMATICAL SOCIETY
CUMANN MATAMAITICE NA hEIREANN
APPLICATION FOR ORDINARY MEMBERSHIP
Please use
BLOCK CAPITALS when ompleting this form
Surname:
Forenames:
Title (Professor, Dr, Mr, Ms, et.):
Oupation:
Plae of Work:
Mathematial Qualiations or Interests:
If you are a member of one of the following soieties and you wish to apply for reiproity
membership of the Irish Mathematial Soiety, then please tik the appropriate line:
[
℄ I am a member of the Amerian Mathematial Soiety
[
℄ I am a member of the Irish Mathematis Teahers Assoiation
[
℄ I am a member of the German Mathematial Soiety
[
℄ I am a member of the Spanish Royal Soiety for Mathematis
[
℄ I am a member of the New Zealand Mathematial Soiety
P.T.O.
I wish to apply for
membership of the Irish Mathematial Soiety
Signed:
Date:
Address for orrespondene:
email address:
I would/would not like to reeive hard opies of the IMS Bulletin (please delete as
appropriate)