To join NAMS, print this form, fill it out and send to:

Dr. Donald Van Nieuwenhuise
NAMS Treasurer
Geosciences Department
Office: SR1-221C
University of Houston
Houston, Texas 77204-5007

Title _____________ Name _______________________________________________

Company/ Institution ____________________________________________________

Address ______________________________________________________________

City_________________________________ State_____________ZIP_____________

Country_______________________________________________________________

Phone___________________________E-mail ________________________________

Specialization: Primary ____________________________________________
                         Secondary __________________________________________

Status: (circle one)    academia    industry    consultant    government    student    retired

Renewal? yes no

New application? yes no

Micropaleontology subscriber? yes no (If yes, your dues are $0.00)

Enclose a check payable to NAMS, SEPM for $10 for every year of membership desired ($5 students), up to five years prepaid.

Amount enclosed:__________________ Years Paid:___________________________