Please fill in this form, and sent it by E-mail to 

Membership Application

I am sending my membership application for JSPP.

Name:

Sex [Male] or [Female]:

Birth Day/Month/Year:

Home address:

Home telephone number:

Home Fax number:

E-mail:

URL of your homepage on the Internet (if you have):

Present occupation, and if affiliated with an institution, your position:

Institution's name:

Institution's address:

Institution's telephone number:

Institution's FAX number:

Education
Degree and Qualification:

Professional organizations of which you are a member:

Specialty Fields:

Your interesting fields in parapsychology:

Your Interest for our society:

Sending address from JSPP [Home] or [Institution]:

Name of a member of JSPP if you've asked him to recommend you.: