TENNESSEE ACADEMY OF SCIENCE
MEMBERSHIP Application or Renewal
Membership is open to all persons interested in science. If you would like to join the Academy
or renew your membership, please complete this form and send it with a check made payable to
the Tennessee Academy of Science to Dr. Steve Murphree, Treasurer, Tennessee Academy of
Science, Department of Biology, Belmont University, Nashville, TN 37212-3757.
Name:
Position or Title:
Mailing Address:
Date:
City:
Phone:
E-mail:
State:
Fax:
Zip:
New Members: please indicate your scientific discipline or interest (check maximum of five):
Astronomy
Chemistry
Geology
Math and Science Teaching
Microbiology
Botany
Engineering
Geography
Mathematics/Computer Science
Physics
New Members: Regional Affiliation:
West
Cell and Molecular Biology
Ethics in Science & Technology
History of Science
Medical Science
Zoology
Middle
East
Please check appropriate membership (dues Jan. 1 – Dec. 31 of each year):
Regular $40
Supporting $100
Sustaining $50
Student $10
Emeritus $10
Life $400 (a single payment)
Amount:
Voluntary Contribution:
Total Enclosed:
$
$
$
Members receive the Journal of the Tennessee Academy of Science, a Call for Papers and the Program of the Annual
Meeting. All papers and posters presented at meetings of the Academy must be authored or co-authored by a
member of the Academy.
I do
website.
I am
I do not agree to allow the information given above to be posted on the TAS
I am not available to serve as a judge for science fairs in my area
I am
I am not available to participate in the TAS NETWORKS PROGRAM as a
Networks Scientist available via email to K-12 students across Tennessee.
Signature: