Because of the way PHP and MySQL read information you will have to replace any quotation marks in any of the fields with """ and any apostrophes with "'"
species names (ie. italics) as <i>Genus species</i>, bold face as <b>bold</b>
Codes for other special characters are available at XHTML Character Codes:

Please fill in all fields marked with an *:

Carcnet Application Form - NEW MEMBERS

Renewing members - Click here

Title: Dr. Ms Miss Mrs. Mr.
*First Name:
*Last Name:
Institution:
Department:
PO Box/Building/Unit:
Street Address:
City:   
Province/State:    Postal/Zip Code:
Country:

Telephone Numbers - format xxx xxx xxxx

Home:
Work:
Cell:
Fax:

Contact Email:
Interests

*Membership Type:

Non-Student:	Student:
1 yr $20.00	1 yr $10.00
5 yr $100.00	3 yr $30.00

Please print this form BEFORE submitting it.
Submitting this form will add your information to the CARCNET members database but you will still need to print it and mail it with your cheque to:

Jose Lefebvre Acadia University Department of Biology 33 University Avenue Wolfville, NS B4P 2R6

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