Member Application Form

Become a member

All applications are subject to the approval of the MSC-SMC.
 

General information
Salutation:
First Name:
Last Name:
Address:
City:
Country:
Province:
Postal Code:
Email:
Comfirm:
Telephone: x
Cellphone:
Fax
University or Employer:
Position:
Department:
Lab or PI:
Education (Degrees, Diplomas, Institutions and Dates):
Field of Microscopy:
 Physical
 Materials
 Biological
 Biomedical
 Instrumentation
Other field: 
Specific Area of Interest:


Login credentials
Password: 6-10 chars.
Confirm password:

Membership Options:
  1 year5 years
Ordinary Member $40
$200
Retired Member $28
$140
Corporate Member $195
$975
Student (Need a validation by the supervisor) $15
$75
Associate Member $0
$0


Canadian Anti-Spam Legislation
I opt in to receiving emails as per the Canadian Anti-Spam Legislation.

Bulletin Newsletter
I do not want to receive the Bulletin newsletter (sent 3-4 times per year).

Donation to Canadian Foundation for the Development of Microscopy
The CFDM is a branch of the MSC to promote student development in microscopy fields.
Amount given to the CFDM: $

Payment
All fees are in Canadian Dollars.

I would like to receive a receipt



Name on card:
Credit card number:
Expiration:  
3 digit CVV number (on back):



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