Full Name : Current Position : Address 1 : Address 2 : City : State/Province : Postal Code : Country : Phone : Fax : Email : Language of Publication : Other Languages : Date of Birth : Nationality : Education (degrees, subjects, and years) :
Are you a member of any other science writers association? No Yes If so, please name it and state any offices held.)
Do you work on a regular basis for any media, publisher, or scientific organization? No Yes (If so, please name it, state position held, and for how long. Indicate any freelance work, too.)
What was your experience in science communication before assuming your present post? (Please give a brief outline of your career.)
List any major published works (books, scripts, etc.):
Please give any additional information you feel is relevant, i.e. membership in clubs, scientific institutions, etc.
I, the aforementioned above, hereby apply for membership of the International Science Writers Association and undertake to maintain its standards of conduct, to accept its decisions, and to do all I can to advance the status of the science-writing profession.
Date : Anti-spam word: Type this word exactly as written in the above textbox: BUJ84 This will be emailed to: James Cornell, President International Science Writers Association 6666 N. Mesa View Terrrace Tucson, AZ 85718 Telephone: (520)-529-6835