INTERNATIONAL PHONETIC ASSOCIATION Membership Form

Print this form and mail/fax to:

The Treasurer (Michael Ashby)
International Phonetic Association
c/o Department of Speech Hearing and Phonetic Sciences
UCL (University College London)
Rm 323, Chandler House
2 Wakefield St
London WC1N 1PF
U.K.

Fax: +44 20 7679 4010

Please enrol me as a member of the International Phonetic Association, and send me the Journal of the IPA as it is issued (3 numbers per year, published by Cambridge University Press) at the postal address below.

Please type or use BLOCK CAPITALS.

Membership Information
New/Renewal:
Title:
Surname:
Other names:
Email Address:
Postal Address:
Telephone:
Fax:
Contact information will be published in JIPA unless you make a request to the contrary. Please indicate if you do NOT wish any of the following to be published.
Do NOT publish:
Institutional Affiliation Address
(if different from postal address):
Nationality:
Profession:
University Degrees or other distinction:
Payment
Membership Type:

If applying for student membership, this form should be accompanied by a letter from the student's department certifying full-time student status.
Amount:

Those wishing to pay in pounds sterling or U.S. dollars should first contact the Treasurer for the current rate.

If paying for multiple years, please state currency and amount of payment: _______________
Payment Method:

Transaction number: ________________________
Please charge my [ ] for the above amount.

(For security, send this information by post or by fax, if paying by card. Please do not send the form as an email attachment.)

Card No: ________________________

Expiry Date: ________________________

Name as registered with the card company: ________________________

Address as registered with the card company: ________________________________________________

Signature: ________________________