Join or Renew 2008 Membership to the American Society for Reproductive Immunology

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Join or Renew 2008 Membership

The purpose of the ASRI is to encourage the study of the immunology of gamete physiology, the fetal-maternal relationship, and of reproductive tract malignancy. Membership is open to all individuals who have exhibited an interest in, or have contributed to, the objectives of the ASRI.

Membership is on a calendar year basis (January through December). Use this form to apply. We accept checks, Visa and MasterCard.

This application/renewal occurs in two parts: membership information and payment. After you submit and confirm your membership information, be sure to continue on to the payment form if you are paying by credit card. If you are paying by check, you will be given instructions to print the form along with an address. Your application/renewal will not be complete until payment is received.

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Application for Membership (or Membership Renewal) 2008

First Name:

Middle Name:
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Last Name:

Degree:

Academic Title:

Administrative Title:

Institution/Company Name:

Department:

Address:

City:

State:

Zip Code:

Country:

Telephone:

Fax:

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Regular Member: $220 (US)
Includes a subscription to the American Journal of Reproductive Immunology & a significant reduction (often 50%) in the registration fee for the annual meeting.

	Associate Member (with Journal): $50 (US) Available for graduate students, residents, post-doctoral fellows & junior research associates for up to a five year period. Include a curriculum vitae & signed letter from your faculty supervisor documenting your status. Includes a subscription to the American Journal of Reproductive Immunology.
	Associate Member (without Journal): $25 (US) Available for graduate students, residents, post-doctoral fellows & junior research associates for up to a five year period. Include a curriculum vitae & signed letter from your faculty supervisor documenting your status.

This is a:

New Membership^*

^* If this is a new application please enclose a copy of your curriculum vitae (CV). If involvement with reproductive immunology is not documented on your CV, then please include a letter of reference from an ASRI member.

Membership Renewal

Member Since:
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Date of Birth:
MM/DD/YYYY

Gender:

Supporting ASRI Member:

Type of Scientist:
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Basic scientist

Clinical laboratory scientist

Human/Clinical Scientist

Large animal scientist

Other, please describe:

Field of Interest:
Check all that apply

Please include up to 10 keywords related to your topics and interest

Cellular immunology and immune regulation
Keywords:
(e.g., NK cell, Macrophage, T-cell, B cell)

Clinical laboratory immunology
Keywords:

Clinical reproductive immunology
Keywords:
(e.g., Implantation, Hormonal aspect in immune response, Neuro-immunology, Recurrent pregnancy losses, NAIT/ Autoimmune thrombocytopenia, Preterm, Infertility, Autoimmune diseases and reproduction, Endometriosis, Premature ovarian failure, HIV, STD, Vaccine development, Oncology/tumor immunology, Toxemia, Hypersensitivity)

Immunogenetics
Keywords:
(e.g., MHC complex)

Inflammation and reproduction
Keywords:

Molecular and structural immunology
Keywords:
(e.g., Cytokines,Complement, Angiogenesis, Implantation, Molecular biology)

Mucosal immunity/ Host defense
Keywords:

Other
Keywords:

Ethnic Background:
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Providing the following information about your background is voluntary. This information will be used for federal grant purposes.

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Asian, East Indian, Asian American, Pacific Islander

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Technical problems? E-mail: webmaster@theasri.org

Questions about membership? E-mail: Stephanie Lee, Executive Officer

ASRI Federal Tax ID #: 13-3390665

We wish to extend a special thank you to our supporters.