International Society for Disease Surveillance Membership

 

Membership Registration

Please provide the following information for your membership:

First Name:
Last Name:
Degree(s):
Title:
Department:
Organization:
Occupation Category (select one):
    If "Other", please describe:
Address:
 
City
State, Province or Territory
(USA or Canada only)
Zipcode or Postal Code
Country:
Phone:
Fax:
Email:
 
Please indicate if you are interested in these ISDS committees (Check as many as you like):
Annual Conference Planning
Global Outreach
Research
Education and Training
Public Health Practice
 
I agree to receive Society notifications by e-mail
I am a full time student (discounted membership rate of $35).

Payment Type for the Registration Fee (Regular $50, student $35):
Credit Card. PLEASE NOTE: To complete the membership process, after submitting payment, click on the link from PayPal to "Return to International Society for Disease Surveillance."
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