EACR Group Membership Application Form Membership Category Please fill out and return this form electronically in order to provide members of your group with individual EACR membership. We will then send you a group invoice for payment. We will write to individual members of your group so they may complete their own membership profile. On registering a group you qualify to become an EACR Ambassador. As an Ambassador you will be credited with points based on the members in your group (see table, right). These points can add up to a free registration at an EACR Congress or meeting in the EACR Conference Series. Membership Fees Active Member (Active) Young Investigator Member* (YI) * Must have less than 4 years postdoctoral experience when joining Student Member*(SM) * Must already have an academic degree and be pursuing postgraduate studies €40 for 1 year €120 for 4 years (25% saving!) €60 for 4 years membership Ambassador Points 0 3 2 €25 for the duration of your postgraduate studies (max. 4 years) 1 At the start of the next membership year (January 2016) you will be updated with your group’s information and have the option to add/replace members to it. Please send your completed form via email to Andrew Binns (andrew.binns@nottingham.ac.uk). Please ensure you add your own details to the first line of the form below. Title Title Title Title Title Title Title Title Title Title Title First Name Add text Add text Add text Add text Add text Add text Add text Add text Add text Add text Surname Add text Add text Add text Add text Add text Add text Add text Add text Add text Add text Email address Add text Add text Add text Add text Add text Add text Add text Add text Add text Add text Type of Membership (Active / YI / SM) Membership Membership Membership Membership Membership Membership Membership Membership Membership Membership PhD End Date (dd/mm/yyyy) For Students Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date PhD Gained Date (dd/mm/yyyy) For Young Inv. Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Add text/date Total: Please provide us with your invoice details (to be sent by PDF email): Name on invoice: Click here to enter text Email address: Click here to enter text Address: Please provide full postal address Please note: membership fees cannot be reimbursed during the year but will be assessed on a pro rata basis each January in light of changes to your group. Membership Fee (€) Fee Fee Fee Fee Fee Fee Fee Fee Fee Fee € Add Fee