CHINESE ASSOCIATION
of
PROFESSIONALS IN SCIENCE AND TECHNOLOGY

Membership Application Form

Last Name(English) First Name(English)
Name(Chinese) Fax
Home Phone Office Phone
Company/Institution Title
Mailing Address
E-mail
Home Page


A. Education

Degree
Institution
Date
Field
Bachelor
Master
Ph. D.


B. Primary responsibilities of current employment (no more than two)

Administration/Management
Basic/Applied Research
Consulting
Manufacturing/Engineering Design
Sales/Marketing
Teaching
Other(specify)


C. Expertise in specific topic isssue(s)





D. Type(s) of CAPST activity(ies) you would like to join

Science/Technology Program CAPST Publication Task Force of Special Event(s)
Other(specify)


E. Wold you like to publicize your name in the Members Directory?

Yes No


F. Membership

Full Membership ($10/year) Family Membership ($15/year) Student Membership ($5/year) Corporation Membership ($100/year)

Please print this form, fill it out and send it to Ying Tong with a check, or you can fill out this form right here. But either way, the check is a must and should be made payable to CAPST.
Also, for more information: contact
Ying Tong
5606 Bissonnet #134
Houston, TX 77081
Phone/Fax: (713) 792-5150
E-mail: ytong@utmmg.med.uth.tmc.edu
This page is maintained by Mumian Gao, Jun Yang