Czech Aerosol Society

Registration

To become a member of the Czech Aerosol Society, please fill in and submit the registration form below and wait for the decision of the Board of the CAS. If accepted as a member, please pay the annual registration fee, which is 100 CZK for full membership or 30 CZK for student membership. The fee can be paid by a bank transfer to the account 159904888/0300. Please inform the Treasurer of CAS about your payment.

First name

Last name

Title

Affiliation

Address

Postal code and city

Country

Telephone

Fax

E-mail

Additional information

I am a

		full member of CAS
		student member of CAS
		non-member of CAS

I am sending this form

		because of my address has changed
		as a member registration
		as a general note to you
`Ochrana proti spamu. Kolik je dvakrát tri?`