Directory Information Form

Please send the following information by e-mail or normal mail:

NAME: __________________________________________________

POSITION: _______________________________________________

DEPARTMENT: ___________________________________________

INSTITUTION: ____________________________________________

STREET ADDRESS: ________________________________________

CITY: ____________________________________________________

STATE: ________________ POSTAL/ZIP CODE: _______________

COUNTRY: _______________________________________________

MAJOR FIELD(S) OF INTEREST: ______________________________

TELEPHONE NUMBER: ______________________________________

FAX NUMBER: _____________________________________________

ELECTRONIC MAIL ADDRESS: _______________________________

WEB SITE/PERSONAL PROFILE/PUBLICATION LIST LINK: _______