ISCOWA Secretariat
c/o Beekstraat 17
6301 HV Valkenburg a/d Geul
The Netherlands.

I herewith declare to want to become a member of ISCOWA, The International Society for the Environmental and Technical Implications of Construction with Alternative Materials, and to observe its Statutes.

Name:

Affiliation:

Full Address:

Signed at (place):	Date:	Signature:

Please circle the ISCOWA working groups in which you are interested in participating:
A. Environmental impact assessment and laboratory testing
B. Technical developments and materials management
C. Public perception and implementation of waste utilisation

I will pay my membership fee of EUR 50.- (= ca. UK£ 35 / US$ 73 ) for 2008 as follows:
[  ]Yes, as new member, please send me the ISCOWA/Wascon 2003 CD-rom for only EUR 25. (please check box)

[  ]Preferred method: I will deposit € 50.-- (or € 135 for 3 years) into ISCOWA's International Bank Account Number (IBAN): NL64PSTB0005964571, with Postbank, Netherlands (BIC/Swiftcode: PSTBNL21), all costs to payer (or within NL: transfer to postgironr. 5964571).

[  ] Charge my [  ] American Express or [  ]VISA or [  ]MasterCard credit card for [  ] € 50 (year 2008) or [  ] € 135 (years 2008, 2009, 2010) + € 25 for the CD-rom if checked.

Please fill in your credit card information:

Credit Card nr:

(the 3 extra digits at the back of your credit card) CVC-code:

Expiration date:

Name as stated on the credit card:

Address to which the credit card is registred:
Please include ZIP or postal code!