U.S. Metric Association membership application
Individual membership (U.S.: $30/year, $58/2-years, $85/3-years; full-time student: $15/year; outside U.S.: $35/year; lifetime: $500 one-time only)
| Name | ___________________________________________________ |
| Affiliation (optional) | ___________________________________________________ |
| Address | ___________________________________________________ |
| City, state (or province), ZIP (or postal code) | ___________________________________________________ |
| Country | ___________________________________________________ |
| Home phone number (optional) | ___________________________________________________ |
| Work phone number (optional) | ___________________________________________________ |
| E-mail address | ___________________________________________________ |
Business/Government membership ($150/year, includes six copies of each issue of Metric Today)
| Business name | ___________________________________________________ |
| Contact person | ___________________________________________________ |
| Address | ___________________________________________________ |
| City, state (or province), ZIP (or postal code) | ___________________________________________________ |
| Country | ___________________________________________________ |
| Phone number | ___________________________________________________ |
| Fax number | ___________________________________________________ |
| E-mail address | ___________________________________________________ |
Credit cards are accepted for payment. To pay by credit card, send the following information:
| Cardholder name (as shown on card) | ___________________________________________________ |
| Credit card type (VISA or MasterCard only) | ___________________________________________________ |
| Card number | ___________________________________________________ |
| Expiration date (mm/yy) | ___________________________________________________ |
| Cardholder signature | ___________________________________________________ |
| Amount to charge: $ | ___________________________________________________ |
Mail this form (and a check, if not paying by credit card) to:
U.S. Metric Association, Inc., 10245 Andasol Avenue, Northridge CA 91325-1504