Application for INDIVIDUAL membership

Document Sample
Application for INDIVIDUAL membership Powered By Docstoc
					                  ENHR                               Application for INDIVIDUAL membership



   Phone:                                                    Email:

   Fields of interest:

   Memberships Fee for one year:
   Individual researchers: 48 EURO                 Students: 24 EURO
   Special rates are available for individuals from countries outside the group of original EU member states. See the
   website at ( for more information).
   Individuals who are employed by an institutional Member of the ENHR do not have to pay an individual fee – return
   the form anyway, to be sure to receive forthcoming issues of the Newsletter. To pay for two or three years at a time,
   just multiple the correct rate by the number of years desired.

    Credit Card      [ ] VISA        [ ] Eurocard         [ ] Mastercard      [ ] American Express

                     Card No:
                     Expire date:
                     Name of Cardholder:
                     Security code (3-4 digits):
                     Today’s date:


                     Please sign this form and send it via postal mail to: ENHR Secretariat, Institute for Housing and
                     Urban Research, Uppsala University, PO Box 785, SE-801 29 Gävle, SWEDEN. Do not fax your
                     signature as the bank that handles the credit card payments requires an original signature.
                     Please notes that the actual amount (in Euro) deducted from your account may be slightly less or
                     slightly more than stated fee because we are forced to adjust the exchange rate each week.

    Bank             Bank transfers can be paid to one of the following accounts. Be sure that your name is clearly
                     indicated on any bank transfer, and that the payment is to the Uppsala University, Institute for
                     Housing and Urban Research, ENHR.
                     PlusGirot                                             Nordea
                     SE-105 71 STOCKHOLM                                   SE-105 71 STOCKHOLM
                     SWIFT: NDEASESS                                       SWIFT: NDEASESS
                     IBAN No: SE10 9500 0099 6034 0954 4982                Account No: 3863 77 04727
                                                                           IBAN No: SE66 3000 0000 0386 3770 4727

   ENHR, Institute for Housing and Urban Research, Uppsala University
   Postadress                        Gatuadress                            Telefon                       Telefax
   Postal address                    Visiting address                      026-420 65 00                 026-420 65 01
   PO Box 785                        Rådhustorget                          Phone                         Email
   SE-801 29 Gävle                                                         +46 26 420 65 00              ENHR@IBF.UU.SE