FACSIMILE TRANSMITTAL SHEET


To: Ms. Wafa Abou-Zaki From:
Fax: (202) 994-3081 Pages:
Phone: (202) 994-1642 Date:
Re: ASC Membership

American Society for Cybernetics

Membership Application

 

Please enroll me as a member of the American Society for Cybernetics.

___ Regular Membership ($50) Annually

___ Student Membership ($25) Annually (Please send a copy of your student ID)

 

First Name:  
Last Name:  
Address:  
City:   State, ZIP Code:  
Email:  
Telephone:   Fax:  
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Send checks or money order to:

American Society for Cybernetics
2101 F Street NW, Suite 201

Washington, DC 20052