2016 MEMBERSHIP FORMMEMBER INFORMATION
Name: Institutional Affiliation: Position: Mailing address:
Landline Number: Mobile Phone Number:
Primary email address: Secondary email address:
EDUCATIONAL BACKGROUNDDegree Major Institution Year
RESEARCH INFORMATIONResearch interests:
Membership in other professional associations:
MEMBERSHIP CATEGORYPlease tick the membership category applicable to you:☐ One year membership for undergraduate students (PhP 800)☐ One year membership for regular members, including graduate students (PhP
1,000)☐ Three year membership for regular members (PhP 2,700)All members will receive a complimentary copy of Philippine Sociological ReviewSignature: Date:
Membership fees may be paid at the registration desk during the conference or through bank payments to: Philippine Sociological Society, BPI Loyola Branch. Account number 3081084032 (current account). Please enclose a scanned copy of the deposit slip to this form and email to: [email protected]
