EUROMICRO
The European Association for Microprocessing and Microcomputing

MEMBERSHIP APPLICATION FORM

[ ] Yes, I wish to become a member of EUROMICRO for 57 EURO per year
   (renews automatically if not cancelled before end of the year)

Name_______________________________________________________________

Company/Univ.______________________________________________________

Department_________________________________________________________

Address____________________________________________________________

City_______________________________________________________________

Country____________________________________________________________

Telephone_________________________  Telefax________________________

EMail______________________________________________________________


Payment will be made by bank transfer:

   EUROMICRO
   IBAN: NL53 INGB 0115 7371 38
   BIC / SWIFT code: INGBNL2A
   Account number: 0115 7371 38
   Branch code: INGBNL2AXXX

   ING Bank N.V.
   Foreign Operations
   PO Box 1800
   1000 BV Amsterdam


Date ______________________   Signature ____________________________

Please enclose/transfer payment for 57 EURO
and return the copy of this completed and signed form to:

EUROMICRO
Drienerstraat 75
7551 HL Hengelo
Netherlands

EMail: office (at) euromicro.org