Membership application
prefix ( ❏ prof.
❏ Dr.
❏ Mr. ❏ Ms.)
First name _____________________________________ M.I. ______ Last name ______________________________________ Company __________________________________________________ Job Title ________________________________________ Mailing Address _____________________________________________________________________________________________
please specify:
❏ Home
❏ Work
City ___________________________________________ state or province ___________________________________________ postal Code/Zip + 4 ______________________________ Country __________________________________________________ Telephone # ____________________________________ Fax #_____________________________________________________ E-Mail __________________________________________
❐ IAFP occasionally provides Members’ addresses (excluding phone and E-mail) to vendors supplying products and services for the food safety
US $ 55.00 Canada/Mexico $ 55.00
industry. If you prefer NOT to be included in these lists, please check the box.
MEMBErSHIPS
International $ 55.00
❏ IAFP Membership
(Member dues are based on a 12-month period and includes the IAFP Report)
optional Benefits:
❏ Food Protection Trends ❏ Journal of Food Protection ❏ Journal of Food Protection Online ❏ All Optional Benefits – BEST VALUE!
Add $ 60.00 Add $150.00 Add $ 45.00 Add $200.00
$ 75.00 $170.00 $ 45.00 $235.00
$ 90.00 $200.00 $ 45.00 $280.00
❏ Student Membership
(Full-time student verification required)
$ 27.50
$ 27.50
$ 27.50
optional Benefits:
❏ student Membership with FPT ❏ student Membership with JFP ❏ student Membership with JFP Online ❏ All Optional Benefits – BEST VALUE!
Add $ 30.00 Add $ 75.00 Add $ 22.50 Add $100.00
$ 45.00 $ 95.00 $ 22.50 $135.00
$ 60.00 $125.00 $ 22.50 $180.00
SUSTAINING MEMBErSHIPS ❏ GoLD ❏ SILvEr ❏ SUSTAINING
Recognition for your organization and many other benefits. $5,000.00 $2,500.00 $ 750.00 BANK
TOTAL MEMBERsHIp pAYMEnT
Contact the IAFp office for more information on the sustaining Membership program.
Payment must be enclosed for order to be processed • US FUNDS on US BANK Payment must be enclosed for order to be processed • US FUNDS on US
❏ Check Enclosed ❏ Visa ❏ MasterCard ❏ American Express ❏ Discover
CREDIT CARD # _________________________________________________________ CARD ID # _________________________Exp. DATE __________________________ sIgnATuRE _____________________________________________________________
* Visa, MasterCard and Discover: see 3-digit Card ID number on the back of the card after account number. *
$ _____________
All prices include shipping and handling prices effective through August 31, 2011
4 EASy WAyS To JoIN
PHoNE +1 800.369.6337; +1 515.276.3344 FAX +1 515.276.8655 MAIL 6200 Aurora Ave., suite 200W Des Moines, IA 50322-2864, usA WEB SITE www.foodprotection.org
MAY 2011 | FOOD PROTECTION TRENDS
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http://www.foodprotection.orghttp://www.foodprotection.org
Table of Contents for the Digital Edition of Food Protection Trends - May 2011