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Payment
Form (download)
Notes
1. Please complete this form and send by fax to +886-3-427-5336, Prof. Jie-Chi Yang,or scan this form and
email it to yang[at]cl.ncu.edu.tw.
2. A confirmation notice will be sent to your email account right after your payment is received.
3. APSCE Membership Subcommittee reserves the right to approve, or refuse membership.
Personal Information
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First name:
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Last name:
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Institution name:
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Country / Region:
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Email:
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Payment Details
We prefer to receive membership fees by credit card. If you prefer to pay by other payment methods, please contact to Administrative Secretary Prof. Jie-Chi Yang at yang[at]cl.ncu.edu.tw.
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Credit Card Information
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Method of payment
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○Visa
○MasterCard
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Name on the card
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Expiry date: Month
Year
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Card Number
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__________ －__________ －
__________
－ __________ －
__________*
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Membership fee |
○US$40(Member)
○US$10(Student) |
Journals
subscription fee |
 US$40(for three RPTEL journals a year) |
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Amount
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US$ __________ (please fill in the amount)
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Signature
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Date:
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*Security Code: Credit cards
have 3 extra numbers on the back.
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