Name of Member (or Organisation if Corporate member):
Membership Category (circle one): Corporate / Individual / Student
Postal Address (including contact person for Corporate member):
Topics of Current Interest in Pattern Recognition:
Institution Certification of full-time enrolment (if student member):
APRS membership fees: Corporate $100, Individual $30, Student $15.
Please print this form and return with your remittance to:
Tony AdriaansenPhone: +61 2 96532274Mobile: +61 402388270email: firstname.lastname@example.org