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: http://www.astrosociety.org/pubs/mercury/institutionprint.html
Дата изменения: Mon Jul 30 02:31:34 2012 Дата индексирования: Tue Oct 2 00:20:30 2012 Кодировка: Поисковые слова: arp 220 |
Please fill out the form below and mail or fax to:
ASP
Attn: Membership
390 Ashton Avenue
San Franciso, CA 94112
Fax orders to: 415-337-5205
Subscription Type: |
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Subscription rate is $72 per site. ___ New Order ___ Renewal Reminder: ASP Membership benefits are not included with the new Institutional Mercury Subscriptions. If you wish to receive these benefits, you must join the ASP as an Individual or Technical Member. More information on membership. E-mail address
for notification of electronic Mercury posting:_________________________________________ |
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IP Addresses Enter your IP address(es) or range below for the subscribed site (campus or department). |
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Institution Information |
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ASP Account Number |
_____________________________________________________
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Institution Name |
_____________________________________________________
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Institution Mailing Address |
_____________________________________________________
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Address 2 |
_____________________________________________________
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City |
_____________________________________________________
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State |
________
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Zip |
_____________________________________________________
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Country |
_____________________________________________________
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Contact Information |
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Contact First Name |
_____________________________________________________
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Contact Last Name |
_____________________________________________________
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Business Phone |
_____________________________________________________
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_____________________________________________________ |
Billing Information - Please select one method of payment |
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Purchase Order # or Reference # |
_____________________________________________________ |
Payment by check |
Please make checks payable to ASP. |
Credit Card Type |
___ Visa ___ MasterCard ___ Discover |
Credit Card Number |
_____________________________________________________ |
Expiration Date (MM/YY) |
_____________________________________________________ |
Help us get to know you |
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How would you categorize your Institution? |
___ University
Library |
___ Occasionally, we exchange our membership list with organizations whose products or services we believe may be of interest to our members. If you prefer that we do not share your name, please check this box. |
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