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International Computer Music Conference

September 25th-30th 1997

THESSALONIKI - GREECE
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ICMC 1997
ICMA MEMBERSHIP FORM

Delegates who join the International Computer Music Association (ICMA) are entitled to ICMC 97 registration discounts (25% or more), waiver of submission fees, as well as the triannual newsletter ARRAY and other membership benefits.

If you wish to join or to renew your membership, please complete this form. Please check your membership type and enter the amount of payment. ICMA membership payment must be made in US dollars and should be paid separately from all payments for the con ference.

Please print or type:

First Name: ____________________________________________________________

Last Name: _____________________________________________________________

Institution: ___________________________________________________________

____ check here if the institution name is part of the mailing address

Mailing Address: _______________________________________________________

City/State/Province: ___________________________________________________

Postal/Zip Code: _______________________________________________________

Country: _______________________________________________________________

Telephone (include country code): ______________________________________

Fax: ___________________________________________________________________

Email: _________________________________________________________________

STUDENTS MUST PROVIDE EVIDENCE OF ENROLLMENT, SUCH AS A COPY OF STUDENT IDENTIFICATION.

Membership:

__ New
__ Renew
__ Former
__ Address Change


Fees:

__ Individual Membership $ 50.00
__ Student Membership $ 15.00
__ Sustaining Membership $150.00
__ Nonprofit Institutional Membership $150.00
__ Corporate Membership $200.00
   
TOTAL PAYMENT: $______


__ I have enclosed a personal check, bank draft or money order from a U.S. bank, payable to the International Computer Music Association

__ Please charge the above fee in US dollars to: __ VISA __ MasterCard

Card Number: _______________________________________________________

Expiration Date: _____________________________________________________

Cardholder's Name: __________________________________________________

Cardholder's Signature: _______________________________________________


For further information please visit the ICMA Home Page