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									                 NEW Membership Application 2011
To join The Clay Minerals Society (CMS), send a copy of this application, along with the required
payments for dues and subscriptions, to The Clay Minerals Society, 3635 Concorde Pkwy Ste 500,
Chantilly, VA 20151-1110, USA ph: (703) 652-9960, fax: (703) 652-9951, e-mail: cms@clays.org.
Membership applications received after October 1, 2010 will be made effective with a paid thru date
of December 31, 2011 unless otherwise requested. The Clay and Clay Minerals (C&CM) journal is
published in February, April, June, August, October, and December. Back issues are mailed to
subscribers to the paper version.



Address Information:
[ ] Dr.         Name:
[ ] Prof                         Given (First)              Middle              Family (Last)
[ ] Mr.         Address:
[ ] Ms.
[ ] Mrs.
[ ] Other
    E-mail:
    Phone:                                                       Fax:


   Make Selection(s):                                                For calendar year Jan-Dec 2011
   (NOTE: you must be a CMS member to purchase the journal)

       [   ] Membership – Elements (no journal)                           $ 60.00
       [   ] Student* - Elements & online access to C&CM                  $ 25.00
       [   ] C&CM paper + online access (US address)                       $70.00
       [   ] C&CM paper + online access (non-US address)                   $85.00
       [   ] C&CM online access                                            $35.00
       [   ] Student* C&CM paper discounted rate                           $40.00
       [   ] Clay Minerals (UK) discounted student/member                  $65.00

                                                                        TOTAL           $
   *Student Certification: (Applicants for student membership must supply the following information.)

   Institution                                               Location
   Degree sought                                             Expected completion date
   A faculty member who can verify your student status:
   Name                                                                   E-mail


   Payment: Please use Visa, MasterCard, Discover, American Express or a check in U.S. dollars, drawn on a U.S. bank,
   payable to The Clay Minerals Society. Do not send credit card information by e-mail.
   US$ ________________ enclosed, or charge my: [ ] Mastercard [ ] Visa [ ] Discover [ ] Amex credit card
   Card #                                                        Exp. Date:
   Cardholder:                                                   Signature:
   Card Verification Value (last 3 or 4 digits above signature panel on back

     For more information, contact The Clay Minerals Society, 3635 Concorde Pkwy Ste 500, Chantilly, VA 20151-1110,
         USA ph: (703) 652-9960, fax: (703) 652-9951e-mail: cms@clays.org or visit the website at www.clays.org.

								
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