icpla 2008 Membership Form
The
International Clinical Phonetics and Linguistics Association
1 Identifying information (Please print or type)
Name:
______________________________________________________________________________________
Mailing
Address: ______________________________________________________________________________________
______________________________________________________________________________________
Telephone: ______________________________________________________________________________________
Fax: ______________________________________________________________________________________
E-mail: ______________________________________________________________________________________
Research
interests:
______________________________________________________________________________________
2
Membership
Options (Note: ICPLA membership
is for the calendar year)
Full
membership
ICPLA
membership only
US$20.00
Student/Retired
membership (supply photocopy evidence of status )
ICPLA
Student/Retired membership only
..
. US$10.00
Clinical Linguistics and Phonetics is the ICPLA official journal. It
appears 12 times per year and full individual subscription is US$608.00.
Members Journal Subscriptions (n.b.
available ONLY with membership; membership cost not included): about $200.00 (to be advised)
DO NOT send money for journal subscriptions, you should contact the Publishers
to arrange this once you have your receipt.
Contact details: email healthcare.journals@informa.com with your receipt details,
and instructions will be given.
TOTAL DUE
...US$________
3 Payment
Options
Check or money
order payable to ICPLA (U.S. Funds only)
Credit Card
payment
Mastercard
Visa
Name (as it appears on the Credit Card): ______________________________________
Credit
Card Number: ______________________________________
Expiration Date: ______________________________________
Signature: ______________________________________
Please return this form to: