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ISSX

INTERNATIONAL SOCIETY FOR THE STUDY OF XENOBIOTICS
NEW MEMBERSHIP APPLICATION
2008
APPLICANT INFORMATION (PLEASE TYPE or PRINT LEGIBLY)

NAME (FIRST) (MIDDLE) (LAST)

HIGHEST EARNED DEGREE(S)

ORGANIZATION DEPARTMENT

STREET ADDRESS/P.O.#

ADDRESS (CITY) (STATE/PROVINCE) (POSTAL CODE) (COUNTRY)

TELEPHONE NUMBER FAX NUMBER

EMAIL:
MEMBER DEMOGRAPHIC INFORMATION
□ ACADEMIC □ GOVERNMENT □ RETIRED/NOT AFFILIATED

□ CONTRACT RESEARCH ORGANIZATION (CRO) □ INDUSTRY
PRIMARY AREA(S) OF INTEREST/RESEARCH
□ ADME IN VITRO □ BIOACTIVATION □ BIOANALYSIS □ BIOMARKERS

□ BLOOD-BRAIN BARRIER □ CARCINOGENESIS □ CHEMOTHERAPY □ CYP ENZYMES

□ DRUG-DRUG INTERACTION □ DRUG ABSORPTION □ DRUG SAFETY □ ECOTOXICOLOGY

□ GENE REGULATION □ HEPATOTOXICITY □ IN SILICO PREDICTION □ IN VITRO/ IN VIVO CORRELATION

□ MASS SPECTROMETRY □ NUCLEAR RECEPTORS □ PHARMACEUTICS □ PHARMACODYNAMICS

□ PHARMACOGENETICS □ PHARMACOGENOMICS □ PHARMACOKINETICS □ PHASE 2 METABOLISM

□ PK-PD □ QUALITY ASSURANCE □ REACTIVE DRUG METABOLITES □ RISK ASSASMENT

□ STRUCTURE-METABOLISM □ TOXICITY □ TOXICOGENOMICS □ TOXICOKINETICS

□ TRANSPORTERS □ VETERINARY DRUG METABOLISM

Return to: INTERNATIONAL SOCIETY FOR THE STUDY OF XENOBIOTICS (ISSX)
Dept. 3462, Washington, DC 20042-3462 USA
Tel. 202.367.1160 | Fax: 202.367.2160 | Email: information@issx.org
Over Please 

40….1..00 $ (LIST OF COUNTRIES AVAILABLE AT HTTP://WWW.……………. INSTITUTION: DEPARTMENT: SIGNATURE OF APPLICANT’S MAJOR RESEARCH ADVISOR: 2. VOL. $75 PRINT & ONLINE □ EUROPEAN JOURNAL OF DRUG METABOLISM & PHARMACOKINETICS.(12)…………………………………………… $318 NORTH AMERICAN.……………. VOL.…(01)………………………… $68 PRINT & ONLINE □ BIOMARKERS.……………………$ □ JAMES R.…(01)……………………………. $255 PRINT □ ……………………………………………………………………………… $270 PRINT & ONLINE □ CHEMICAL RESEARCH IN TOXICOLOGY.……………………….ORG/PAGES/PAGE02A.. ONE MUST HAVE BEEN A REGULAR MEMBER IN GOOD STANDING FOR 20 PREVIOUS YEARS AND AT LEAST 65 YEARS OF AGE) TOTAL CONTRIBUTION SUBTOTAL $ I CERTIFY THAT IS A CANDIDATE FOR AN ADVANCED DEGREE OR A POST-DOCTORAL FELLOW IN A FIELD RELATED TO THE STUDY OF XENOBIOTICS (E. UNRESTRICTED ($250 OR MORE ABOVE ANNUAL DUES). VOL 48. USA OR FAX: 202-367-2160 . PHARMACOLOGY.3 GRAND TOTAL………………….. $293 OUTSIDE EU. NW.……………………………….(12)……………………………………………….(06)……………………………………….. 18…. 2008 JOURNAL SUBSCRIPTION AT MEMBER RATES □ ANNUAL REVIEW OF GENOMICS & HUMAN GENETICS. VOL. PRINT & ONLINE □ …………………………………………………………………………… $281 EU.……………………$ □ MEMBERSHIP FUND (MEMBERSHIP DUES SUPPORT). PRINT □ CURRENT DRUG METABOLISM.$ □ SUSTAINING MEMBER.. VOL. 21….00 $ □ STUDENT MEMBERS $25. GILLETTE AWARD………………………………………………………………….(12)…………………………………………………………………………….……………………$ □ SOCIETY AWARDS……………………………………………………………………………….ISSX.(04)…… $200 PRINT □ PHARMACOGENETICS & GENOMICS... PRINT □ …………………………………………………………………………………………………………………… $419 OUTSIDE NORTH AMERICAN. 9….2.…(08)……………………………………………………. MEMBERSHIP DUES (FOR THE CALENDAR YEAR 2008): □ REGULAR MEMBERS $80.... DC 20036.. WASHINGTON.……….…………….. $60 PRINT □ DRUG METABOLISM REVIEWS. $193 PRINT □ …………………………………………………………………………………………………………………… $208 PRINT & ONLINE JOURNAL SUBTOTAL…………………. VOLUNTARY TAX DEDUCTIBLE CONTRIBUTION: □ GIFT.$ GRAND TOTAL ADD BOXES 1.00 $ (STUDENT/POST-DOCS PLEASE COMPLETE THE BOX BELOW) □ MEMBERS FROM DESIGNATED COUNTRIES $25. VOL. 2025 M STREET.. VOL 23…. SUITE 800.……………………$ TOTAL CONTRIBUTION SUBTOTAL…………$ 3.. VOL 13.……………………$ □ YOUNG SCIENTIST TRAVEL FUNDS……………………………………………………….G... $68 PRINT & ONLINE □ ANNUAL REVIEW OF PHARMACOLOGY & TOXICOLOGY. 33…. PRINT & ONLINE □ XENOBIOTICA. UNRESTRICTED (LESS THAN $250)…………………………………………………………………………. VOL. 38….(04)……………………………………………………….00 $ □ POST DOC MEMBERS $25. VOL 9.(10)………………………………………………………… $235 PRINT □ DRUG METABOLISM & PHARMACOKINETICS.$ CREDIT CARD INFORMATION PLEASE TYPE OR PRINT LEGIBLY □ AMERICAN EXPRESS □ VISA □ MASTER CARD □ DISCOVER CARD NUMBER: EXPIRATION DATE: NAME ON CARD: CVV NUMBER: AUTHORIZED SIGNATURE: RETURN TO: ISSX. TOXICOLOGY).…………….HTML) □ EMERITUS MEMBERS $DUES WAIVED ON REQUEST $ (TO QUALIFY.