Membership application Prefix ( ❏ Prof. ❏ Dr. ❏ Mr. ❏ Ms.) Last Name Job Title First Name M.I. Company 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 industry. If you prefer NOT to be included in these lists, please check the box. MEMBERSHIPS US $ 50.00 Canada/Mexico $ 50.00 International $ 50.00 ❏ 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 $ 36.00 Add $200.00 $ 75.00 $170.00 $ 36.00 $235.00 $ 90.00 $200.00 $ 36.00 $280.00 ❏ Student Membership (Full-time student verification required) $ 25.00 $ 25.00 $ 25.00 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 $ 18.00 Add $100.00 $ 45.00 $ 95.00 $ 18.00 $135.00 $ 60.00 $125.00 $ 18.00 $180.00 SUSTAINING MEMBERSHIPS Recognition for your organization and many other benefits. ❏ GOLD ❏ SILVER ❏ SUSTAINING $5,000.00 $2,500.00 $ 750.00 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 ❏ Check Enclosed ❏ Visa ❏ Mastercard ❏ American Express ❏ Discover CARD ID # * TOTAL MEMBERSHIP PAYMENT $ CREDIT CARD # EXP. DATE SIGNATURE * Visa, Mastercard and Discover: See 3-digit Card ID number on the back of the card after account number. American Express: See 4-digit, non-embossed number printed above your account number on the face of your card. All prices include shipping and handling Prices effective through August 31, 2009 4 EASY WAYS TO JOIN PHONE 800.369.6337; 515.276.3344 FAX 515.276.8655 MAIL 6200 Aurora Ave., Suite 200W Des Moines, IA 50322-2864, USA WEB SITE www.foodprotection.org 132 FOOD PROTECTION TRENDS | FEBRUARY 2009http://www.foodprotection.org http://www.foodprotection.org