ISAI MEMBERSHIP APPLICATION
Headquarters: Department of Computer Science
Texas State University-San Marcos -- San Marcos, TX 78666-4616 U.S.A.
Telephone +1(512) 245-3409 * FAX +1(512) 245-8750 * E-mail ma04@txstate.edu
Please TYPE or PRINT carefully. Reproduction of form is authorized. Return
the completed form with payment to above address (Attn: Dr. Moonis Ali). ISAI
is a non-profit organization incorporated in the State of Texas, U.S.A.
SECTION A: PERSONAL
_____New Member _____Renewal Membership Year: 2008___ Other_______
(year)
1. Circle one: Mr./Mrs./Ms./Dr.
2. Name______________________________________________
(first) (mi) (last)
3. Telephone _______(____)___________________
4. FAX
_______(____)_____________________
country (area) number country (area) number
5. E-mail______________________________________________________
6. Home Address______________________________________
City_____________________________
State/Province________________________ Code (zip)___________
Country________________
SECTION B: EDUCATION
7. Degree(s)_____________________ Date(s)_______ Course(s) of
Study_____________________
Institution(s)_______________________________________________________________________
SECTION C: PROFESSIONAL
8. Title________________________________________________
9. Company Name_____________________________
10. Dept___________________________________
11. Company
Address______________________________________________________________________
State/Province_________________________ Code (zip)__________
Country________________
12. Telephone ______(____)______________________
13. FAX
#______(____)___________________
14. E-mail_____________________________________
15. Area(s) of Expertise__________________
16. Company Activity___________________________
SECTION D: MISCELLANEOUS
17. Preferred Mailing Address: ___home ___business (need full address above)
18. If new, how did you hear about ISAI?________________________________________
19. Who might be interested in becoming an ISAI member? (show name & address):
____________________________________________________________________________
SECTION E: MEMBERSHIP
20. TYPE OF MEMBERSHIP FEE
Benefits include, registration fee discount for $50
IEA/AIE conference and other ISAI sponsored activities.
SECTION F: METHOD OF PAYMENT (Required to process membership).
21. Amount due $__________ in U.S. dollars. (Circle option a. or b. below):
a. Check No._________ (Enclose check payable to ISAI and drawn on a bank
affiliated with the USA)
Bank Name & Location_______________________________________________
Authorized signature:________________________________ Date:__________
b. Select one: __VISA __Mastercard __American Express
Expiration Date: month____ / year ____
Print name exactly as shown on card:_______________________________
Card number________________________________________________________
Cardholder's signature:_____________________________Date:__________
*********************************************************
Dr. Moonis Ali
Department of Computer Science
Texas State University-San Marcos
601 University Drive
San Marcos, TX 78666-4616 USA
FAX: 512-245-8750 EM: ma04@txstate.edu
Information is available on the following WWW pages for the Journal,
the Society (ISAI), or the June Conference (IEA/AIE):
http://isai.cs.txstate.edu
Journal:http://www.springer.com/west/home/computer/artificial?SGWID=4-147-70-35530940-detailsPage=journal|description
University Hours: 8 a.m.-5 p.m. Central Time, Monday through Friday
http://www.maps.txstate.edu/