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Apopuli.164 net.usenix utzoo!decvax!ucbvax!G:usenix Thu Apr 29 10:48:20 1982 Application form for Individual Membership

1982 Application for New Membership USENIX Association Individual or Public Membership

[ ] Individual ($12, Institution has Source License) Institutional Affiliation: ______________________________________________ Nature of Affiliation: __________________________________________________

[ ] Individual ($12, Institution has Binary License Only) Institutional Affiliation: ______________________________________________ Nature of Affiliation: __________________________________________________

[ ] Public ($12, Not covered by Non-Disclosure)

Mailing Address (Individual Members must use institution address): Name: ________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Phone: _______________________________________________________________________

[ ] Overseas airmail, add $5.00

[ ] Invoice required, add $3.00 bookkeeping charge

[ ] Receipt required, add $3.00 bookkeeping charge

Check enclosed:

Return completed form to:

USENIX Association Box 8 The Rockefeller University 1230 York Avenue New York, NY 10021

(For Institutional Membership or membership renewal contact the Association offices at the address above or at 212-570-8934.)

April 1982

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