Mountain States Society of Electron Microscopists - and - Colorado Microbeam Analysis Society (Please print this form and mail to the address below.)

MEMBERSHIP APPLICATION FOR 2008

Membership dues Student Membership dues Corporate Sustaining Membership dues*

$15.00___ $5.00____ $100.00___

Member Name Company Name Mailing Address Email Telephone (Home) (Work)

___________________________________ ___________________________________ ___________________________________ ___________________________________ ________________________ZIP________ ___________________________________ (_____)____________________________ (_____)____________________________

Major Interest: Materials Sciences_______ Biological Sciences________

*Corporate Members may designate an additional member.

Second Corporate Member Name Mailing Address Email Telephone

___________________________________ ___________________________________ ___________________________________ ________________________ZIP________ ___________________________________ (_____)_____________________________

Make checks payable to: MSSEM/CMAS Your check will be your receipt unless otherwise requested.

Mail form/dues to the Treasurer: Julie Pier Rio Tinto Minerals 8051 E Maplewood Ave, Bldg 4 Greenwood Village, CO 80111 Telephone: (303) 713-5207