MEMBERSHIP INFORMATION FORM for
Scientists and Technologists Against Nuclear Dumping (STAND)

Name:

e-mail:

Postal Address:
(needed for "NewClear News", etc.)

Phone:

Student, Y or N?

Degree (or if student, major subject):

If not a student but also seeking concessional membership rate, reason:


I expect my skills/interests make it appropriate for me to be in:
 Life Sciences Division
 Earth Sciences Division
 Physical Sciences Division
 Quantative Social Sciences Division

Scientific skills which seem most appropriate for assisting
STAND in opposing Pangea:




Other relevant skills:



Scientific interests which might be developed to oppose Pangea.