G EOLOGICAL S OCIETY
OF J AMAICA
Department of Geography & Geology, University of the West Indies, Mona Campus, Kingston 7,
JAMAICA - Tel: (876) 927-2728, 927-2129; Fax: (876) 977-6029: E-mail: gsj50years@yahoo.com
MEMBERSHIP REGISTRATION FORM
PREFERRED TITLE:
Ms
Mrs
FIRST NAME: ________________________
Mr
Dr
Prof.
Sir
SURNAME:_________________________________
DEPARTMENT/UNIT:
_____________________________________________________________
ORGANIZATION:
_____________________________________________________________
OFFICE ADDRESS:
_____________________________________________________________
_____________________________________________________________
POSITION:
_____________________________________________________________
TELEPHONE :
________________________
E-MAIL:
_____________________________________________________________
Areas of Interest:
FAX.: _____________________
________________________________________________
Membership in the Society is open to all persons with an interest in Geology and all related earth
sciences. Application for Membership may be submitted to the Secretary/Treasurer, Geological
Society of Jamaica. c/o Department of Geography & Geology, University of the West Indies, Mona,
Kingston 7, Jamaica.
ANNUAL SUBSCRIPTIONS ARE DUE AT THE ANNUAL GENERAL MEETING EACH YEAR OR
BY THE 31ST OF JANUARY.
MEMBERSHIP FEES ( Indicate your status with an asterisk ‘*’)
STATUS ANNUAL FEE (J$)
Institutional
3,000.00
Professional
1,500.00
Associate
500.00
Student
300.00
Donation to the GSJ Scholarship : Amount __________________
Payment method
Cash
Cheque (drawn on a US$ OR J$ Account)
Please make payable to The Geological Society of Jamaica