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THE SOCIETY OF CHINESE SCHOLARS ON EXERCISE PHYSIOLOGYND FITNESS A Membership Application Form (2006) Mission of the Society: The Society of Chinese Scholars on Exercise Physiology and Fitness (SCSEPF) is a non-profit professional organization committed exclusively to the advancement and improvement of exercise physiology and fitness. SCSEPF provides a forum for exchange of information to stimulate discussion and collaboration among exercise physiologists and fitness professionals. Secretarial Only Reg. #:_________________ Date rec'd:______________ I. PERSONAL PARTICULARS 个人资 Prof. Dr. Mr. Mrs. Ms.Miss 教授 博士 先生 太太 士小姐 Surname 英文姓氏 Other Name 英文名字 Name in Chinese 中文姓名 Affiliation 工作单位 Department/Office 学系/部门 Position 职位 Mailing Address 通讯地址 Department 学系/部门 Affiliation 工作单位 Rm./Floor 室/层 Bldg. 大厦 Street 街道 City城市 Province/ State 份 Country 国家 Postal Code 邮政编码 Tel/Fax/E-mail 电话/传真/电邮 ( )-( ) Country & Area Codes 国家及地区编号: Off. Tel. No.办公室电话Off. Fax No. 传真号码 Res. Tel.. No.住所电话 Mobile 手提号码 E-mail Address 电邮地址 II. THE HIGHEST DEGREE EARNED 最高学 Dates 日期 (M/Y) (月/ ) Full Name & Location of Tertiary Institutions Attended Field of Study Qualifications Obtained From 由 To 至 就 院校名称及地址 修 范围 所得资格/文凭/学位 III. MAJOR RESEARCH AREA(S) 主要研究范围 IV. MEMBERSHIP TYPES AND FEE 会员种 及会费 Membership Types Membership Fee 会费: Ordinary Member 普通会员 US$30 / HK$240 per yr. 每 US$30 / HK$240 Associate Member 预备会员 US$25 / HK$200 per yr. 每 US$25 / HK$200 By signing below, I affirm that 1) the statements made by me on this application are correct; 2) I understand that SCSEPF membership is on a calendar year basis: January-December; and 3) the accepted application are non-refundable. 本人特此声明上述资 正确无讹,并明白会费是按 计算的(一月至十二月),并 解会费 可退还. |
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