Membership Application Form

The Japan Wood research Society
1-1-17 Mukogaoka, Bunkyo-ku, Tokyo 113-0023, Japan
Telephone: +81-3-3816-0396, Fax: +81-3-3818-6568,
E-mail:    URL: http://www.jwrs.org/
Prefix: [  ]Mr. [  ]Ms. [  ]Dr. [  ]Prof.
Name:____________________________________________________________________________________
(Last)(First and Middle)
Affiliation (Organization/Company/University):_____________________________________________________
___________________________________________________________________________________________
If you are a student, please provide your supervisor's name:____________________________________________
Mailing Address: [  ]Home  [  ]Business:
  Street/P.O.:_________________________________________________________________________________
  City:________________________ State/Country:_______________________ Zip/Postal Code:______________
  Telephone:_______________________________ Fax:_______________________________
E-mail Address:_______________________________________________________________
Memebership Category (Please check one):
[  ]Full Membership (annual dues: JPY 10000/12000 for individuals in/outside Japan)
[  ]Student Membership (annual dues: JPY 7000/9000 for full-time students in/outside Japan)
[  ]Supporting Membership (annual dues: one or more units of JPY 30000 for individuals or
corporations/organizations, with extra charge JPY 2000 for members outside Japan)
[  ]Institutional Membership (annual dues: JPY 16000/18000 for institutions in/outside Japan)
All membership dues include subscriptions of Mokuzai Gakkaishi and Journal of Wood Science by surface
mail. If you check Subscription by Airmail, you can receive journals by airmail with additional charges
JPY3600 (Asia), JPY5200 (North/Central America, Oceania, Europe), or JPY7200 (Africa, South America):
[  ] Subscription by Airmail
Payment of Membership Dues:
[  ]Please find my check enclosed. (Make checks payable to the Japan Wood Research Society.)
[  ]Please bill my [  ]VISA  [  ]Master Card.
Card No.:_______________________________ Expiration Date (month/year):___________________
Cardholder Name:_________________________________________________________
Signature:__________________________________ Date:_________________________

Please complete this form and send it to the Society's Office by mail or fax.