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September 2009 - The Southeastern Geophysical Society

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Member Information<br />

NAME<br />

<strong>Southeastern</strong> <strong>Geophysical</strong> <strong>Society</strong><br />

Membership Application<br />

Fiscal Year<br />

June 1, <strong>2009</strong> - May 31, 2010<br />

Last First M.I.<br />

Professional Memberships:<br />

SEG Status? Active Associate Student Not a member<br />

Others: ________________________________________________________<br />

_____________________________________________________________________<br />

Undergraduate/Graduate Schools: BA/BS:<br />

___________________________________MA/MS:_______________Other:________<br />

Check here if you prefer to receive your newsletter on paper and specify to which<br />

address below.<br />

Business Address<br />

Company<br />

Address<br />

Phone Fax<br />

E-Mail<br />

Home Address<br />

Address<br />

Phone Fax<br />

E-Mail Spouse's Name<br />

Dues are $20 for Active and Associate Members and<br />

$10 for students. Please make checks payable to SGS<br />

and mail to:<br />

New Member<br />

Renewing Member<br />

<strong>The</strong> SGS is considering publishing an annual directory<br />

in a "Members only" portion of our website. Please<br />

check the applicable box below.<br />

Business Home Both Do<br />

not List<br />

check here if this is your preferred mailing address<br />

check here if this is your preferred mailing address<br />

Secretary<br />

P.O. Box 57141<br />

New Orleans, LA 70157-7141<br />

Cash _____________________<br />

Office Use Only<br />

Check No. ________________<br />

Date Paid ________________<br />

<strong>Southeastern</strong> <strong>Geophysical</strong> <strong>Society</strong> Reflections <strong>September</strong> <strong>2009</strong> 4

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