INTERNATIONAL CONSORTIUM

OF PARSE SCHOLARS

 

 

 

2008 MEMBERSHIP FOrm

 

Name:

Street:

City:

Province/State

Country

Postal/Zip Code:

Telephone:

Email:

Employer or Institutional Affiliation:

Expiration date: 30 November 2008

 

MEMBERSHIP FEES:

FULL MEMBER

ONE YEAR

 

STUDENT MEMBER*

 

International

q    $50.00 CAD  

q    $50.00 US

 

q    $30.00 CAD

q    $30.00 US

Toronto Chapter

q    $60.00 CAD

 

q    $40.00 CAD

Chicago Chapter

q    $60.00 US

 

q    $40.00 US

 

* You must be a full-time nursing student to qualify for this rate.

 

All fees include a $5.00 disbursement to the Lise Perault Scholarship Fund

 

Please send membership form and cheque or money order payable to ICPS to:

Pat Lyon

1 Meredith Ave

Cobourg, Ontario, Canada

K9A 4G6