Please print and mail this form
The Orthopterists’ Society Membership Form
Date ……………………………..
Active Membership US$ 25 *
Sustaining Membership US$ 75 *
Student Membership US$ 10 *
Lifetime membership US$ 600
Sponsored Membership US$ 25 * (does not include J. Orthop. Res.)
Journal of Orthoptera Research per volume (two issues per year, printed copy + online access
via BioOne) US$ 35 *
Journal of Orthoptera Research, online access via BioOne only US$ 15 *
(Note: All Membership categories receive the newsletter, Metaleptea, free)
Optional support for the Orthopterists’ Society
……………… Gift to support the general operations of the Orthopterists’ Society (you specify the
amount)
……………… Contribution to the Orthopterists’ Society Research Fund (you specify the amount;
these funds are used to support a competitive grants program primarily for Graduate
Students and young professionals for BASIC Orthopteran research. Your contribution
will be matched by an anonymous donor.)
Please make checks and money orders payable to the Orthopterists’ Society.
Last Name ……………………………………………. First ……………………………………….. Middle Initial …….
Appelation as you wish it to appear on the mailing label (Mr. Sr, Herr, Ms., Mme, Dr., Prof.,Ing.,
etc.) …………………………….
Address ……………………………………………………………………………………………………………………………………….
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Institution and position ……………………………………………………………………………………………………………….
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Telephone number ………………………………………. FAX number …………………………………………
E-mail address ………………………………………………………………………………………………………………
Website ………………………………………..………………………………………………………………………………
Would you like to sponsor a member?
Research or other interests in Orthoptera (Please be as specific and as extensive as possible as
this will aid members and other biologists in searching for expertise)
We encourage non-U. S. members to use a Visa, Master Card, Eurocard, Discover, and Discover
International (NOTE: we DO NOT accept American Express) to avoid payment problems as well
as to obtain the best exchange rate. Because the Society is charged a monthly service fee by its
bank, we must ask those using credit cards to help defray this expense by adding $2 to their
payment.
VISA or MasterCard Number ……………………………………………………………………………………………
Expiration Date …………………………………………………………
Signature …………………………………………………………………
Please print this form and send to:
Dr. Charles Bomar
Executive Director
University of Wisconsin-Stout
Biology Department
203A Science Wing
Menomonie, WI 54751 USA
Phone: (715)-232-2562
Fax: (715) 232-2129
E-mail: bomarc@uwstout.edu
*Payable in US dollars in cash, by personal check, of by bank draft or international money order
from a foreign bank with U. S. branch offices.
Please note: checks from non-U.S. banks must be from a bank with a cooperating U. S. bank
whose name appears on the check and which bears a bar code on the bottom margin of the
check. Because a service fee of more than the value of the membership dues is charged on all
other checks by our bank, the Society cannot accept these checks.