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CSM Canadian Society of Microbiologists
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CSM Membership Application: Fill in form

Fill in the Membership Application form and Submit.
If payment is by credit card, you will be taken to the PayPal site to process your payment.
You will receive a Confirmation Email once the CSM has received your application.
Contact Information (* Required Fields)
*Title Dr.    Mr.    Ms.    Mrs.
*Last Name   Initials   *First Name
*Degrees
*Job Title
*Department
*Institution
*Address
 
*City
  *Province     *Postal Code 
*Country
*Work Phone
  Fax    Home Phone 
*Email

Background Information
*Section Affiliation
Applied and Environmental Microbiology
Molecular Genetics and Cellular Microbiology
Infections & Immunity
 
*Research Interests
 (maximum of 50 words)
*Keyword 1
Keyword 2
Keyword 3
Keyword 4
Keyword 5

Permissions and Privacy
*Do you consent to having your address used for mailings other than CSM information which are determined to be relevant to your profession? Yes    No
*Do you consent to having your information in the CSM Online Membership Directory? Yes    No

Payment Information
(Please note that GST is included in your membership fees. Your receipt will show membership fees and GST paid.)
*Membership
Ordinary $100.00
Student $30.00
New Undergraduate Student*
(Rate is for first year of membership only)		 $15.00
Post-Docs $30.00
Emeritus $30.00
Honorary Member $0.00
*Can. Journal Microbiology (CJM)
Annual subscription rates
Members with Canadian mailing address $126.00
Members residing outside of Canada $186.00
No subscription $0.00
Payment Total $
*Payment Method Cheque Payment   Credit Card Payment
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Credit card payments will be processed by PayPal (please note that PayPal accepts VISA, MasterCard and American Express).

Section For Students/Postdocs Only
Title of Thesis (if applicable)
Microbiology skills and experience
(maximum of 50 words)
Other skills
(maximum of 20 words)
Career interests
Date available for employment
Supervisor
Supervisor Name
Supervisor Email
Supervisor Phone
Affidavit
Individuals applying for Student or Postdoc membership must provide a signed affidavit from their supervisor.

To submit your affidavit electronically: you will need to scan your signed affidavit using a document scanner and save it to your computer, after which you may upload it using the Upload feature below. If you prefer not to choose this method, you may also submit your affidavit to the CSM.
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