Application form

Online application - Membership

1. Please select your membership category

Company
Individual
Institution

2. Indicate your contact details
* obligatory field

Company Name: *

Website:

Representative

Mr Mrs Ms

First name: *

Last name: *

Organisation: *

Position: *

Address: *

Complement no.1:

Complement no.2:

City: *

Postal Code: *

Country: *

*This address shall be used for invoicing

Phone: *
* Please fill the phone number in the international format
Example: (+33 123 456 789)

mobile: *
* Please fill the phone number in the international format
Example: (+33 123 456 789)

E-mail: *

Second Representative

Mr Mrs Ms

First name: *

Last name: *

Position: *

Address: *

Complément no.1:

Complément no.2:

City: *

Code Postal: *

Country: *

This address shall be used for invoicing

Phone: *
* Please fill the phone number in the international format
Example: (+33 123 456 789)

Fax: *
* Please fill the phone number in the international format
Example: (+33 123 456 789)

E-mail: *

5. Proceed with payment of subscription fees

Payment by: Credit card Credit transfer

Compagnies
	1 Year	2 Years (Discount -10%)
CYA (< 10 employees) one representative included	600 €	1080 €
CYB (> 10 employees) two representatives included	900 €	1620 €
AM Additional representative Join their Company at a reduced subscription rate per additional Member	175 €	315 €
Additional subscription for OS&E in hard copy for additional representative Company representatives recorded in CyA and CyB categories receive Ozone: Science & Engineering journal in hard copy and in electronic format through web access. For additional member, hard copy journal is available with additional subscription	50 €

Individuals
ES Student (supporting letter needed from your supervisor) Students engaged in academic work related to IOA scope	60 €
EL Individual Individual from Low Income Countries (Afghanistan, Albania, Angola, Armenia, Bangladesh, Benin, Bhutan, Burkina Faso, Burundi, Cambodia, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Dem. Rep., Congo, Rep., Côte d'Ivoire, Djibouti, Egypt, Arab Rep., Eritrea, Ethiopia, Faeroe Islands, Fiji, The Gambia, Georgia, Ghana, Guam, Guinea, Guinea-Bissau, India, Indonesia, Iraq, Kenya, Dem. Rep. Korea, Kosovo, Kyrgyz Republic, Lao PDR, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mayotte, Micronesia, Fed. Sts., Moldova, Mongolia, Morocco, Mozambique, Myanmar, Nepal, Niger, Nigeria, Pakistan, Papua New Guinea, Philippines, Rwanda, Samoa, Sao Tome & Principe, Senegal, Sierra Leone, Solomon Islands, Somalia, South Sudan, Sri Lanka, Sudan, Swaziland, Syrian Arab Republic, Tajikistan, Tanzania, Timor-Leste, Togo, Tonga, Turkmenistan, Tuvalu, Uganda, Ukraine, Uzbekistan, Vanuatu, Vietnam, West Bank & Gaza, Yemen, Rep., Zambia, Zimbabwe) and Retired Member (written proof needed)	100 €
EI Individual interested in ozone technology and in the aims and activities of the Association	175 €
Additional subscription for OS&E in hard copy Individual members receive Ozone: Science & Engineering journal in electronic format through web access. Hard copy journal is available with additional subscription	50 €

Institutions
	1 Year	2 Years (Discount -10%)
EA Academic and non-profit organisations wishing to maintain awareness in the field of ozone application & technology	600 €	1080 €

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