Usenix Association Application for Individual or Public Membership For Calendar Year 1983 Please type or print very clearly [ ] New [ ] Renewal [ ] With changes to existing USENIX records Old address: [ ] Individual Membership: $30 [ ] Non-Disclosure covered by institution with source license [ ] Non-Disclosure covered by institution with binary license Institutional affiliation: Nature of affiliation: , [ ] Public Membership (Not covered by Non-Disclosure): $30 Mailing address: Your name: Phone: ( ) Network address: __ [ ] Overseas airmail, add $9.00 [ ] Invoice required, add $6.00 bookkeeping charge Check enclosed: $ Return completed form to: USENIX Association P.O. Box 7 El Cerrito, CA 94530 o £ S a « 3 i 5 s o You will receive a card acknowledging your membership as soon as it is processed. Check #:
