Dues 2010 (Please print this form)

If you want to receive hard copy, please add an extra $ 20/euros 14 (incl. airmail postage) to your Dues:

Please tick the appropriate boxes.

New Member Renewal Change of Address
 
Benefactor US$ 200 Euros 140
Patron US$ 100 Euros 70
Supporting US$ 75 Euros 52
Institutional/Commercial US$ 100 Euros 70
Regular US$ 50 Euros 35
Student US$ 25 Euros 17

Send mailings to my institution/business
Send to my private address

Private Address
Last Name:   
First Name:

  

Street Address:   
City:   
State:   
Postal/Zip Code:   
Country:   
Phone:   
Fax:   
Email:   


Institutional Address

Institution Name:   
Street Address:   
City:   
State:   
Postal/Zip Code:   
Country:   
Phone:   
Fax:   
Email:   

Indicate your method of payment:

MasterCard 
Visa:
Card #:   
Expiration date:   
Signature:   

Please add the code number found on the back of the card

Members NOT paying by credit card

North American Members
Please pay by check if possible. Make check payable in US dollars to HNA, drawn on a US bank. Send completed form and check to Kristin Belkin, 23 S. Adelaide Ave., Highland Park, NJ 08904.

European Members
Pay in your own currency directly to Postbank Berlin.
From Germany: a/c. no. 0744 146 108, bank no.:100 100 10

From other European Countries: IBAN (International Bank Account Number) DE88 1001 0010 0744 1461 08 and BIC/SWIFT (Bank International Code) PBNKDEFF

IMPORTANT! Those European members paying by bank transfer, complete and send this membership/renewal form to Fiona Healy, HNA European Treasurer, Seminarstrasse 7, D-55127 Mainz, Germany

We do not acknowledge receipt of dues.

(Please print this form)

Email Us: info@hnanews.org