PORSEC Membership Form

Name	choose oneDr.MissMr.Mrs.Ms.Prof.   Last: * First: * M.I.:
Mailing address	Street: *
	City: *
	State/Province: *
	ZIP/postal code:
	Country: *
Affiliation (University, Company) *
Position in institution
Email address *
Phone
FAX

Vocation:

	Science
	Engineering
	Education
	Administration
	Supporter/Spouse (non-professional)
	Other:

Scientific Field (please choose up to three):

	Biological Oceanography
	Coastal Oceanography
	Physical Oceanography
	General Oceanography
	Geophysics
	Air Sea Interactions
	Pollution
	Marine Meterology
	Climate Dynamics
	Fisheries
	Other:

Technical Field (please choose up to three):

	Active Microwave
	Passive Microwave
	Visible/IR
	Sensor Technology
	GIS Applications
	Signal Processing
	Other:

PORSEC Involvemnet (past and/or present):

	Member
	SOC
	Officer
	Committee

I am willing to serve PORSEC in the following capacity...

Membership fee: full member $40 for two years.
Student member: $20 for two years.
Lifetime membership: $200.

Payment amount (May include voluntary contribution):

Payment method

	Please invoice me for the amount indicated above for electronic payment through PayPal
	Payment of the above amount made by check drawn on a U.S. bank*
	I would like to defer payment to the next conference

If deferring payment, please indicate the reason and amount:

Please make checks out to:
The PORSEC Association

and mail to:
The PORSEC Association Membership Office
c/o Dr. Gad Levy, NorthWest Research Associates, Inc.
PO Box 3027
Bellevue, WA 98007-3027 U.S.A.

* If the cost of transferring funds internationally is high, choose a different option.

* indicates a required field.

The PORSEC Association is a Non-Profit Association registered in the State of Washington, USA.

For more information about PORSEC Association contact: katsaros (at) porsec (dot) nwra (dot) com