MEMBER
Any person engaged in geological work or research pertaining to geology or the teaching of geology and who devotes the major part of his/her time and receives the major part of his/her earned income from such endeavors is eligible to apply for membership as a member. These requirements shall not be construed to exclude any person now retired or inactive in the profession but who was fully qualified under these requirements when actively engaged in geological work.




AFFILIATE MEMBER
Any person who is interested in any of the Earth Sciences is eligible to membership in the Society as an affiliate, and he/she shall enjoy the privileges of the Society except that he/she shall not hold office, sponsor applications for membership, nor vote; however, an affiliate may be transferred to Member by action of the Board of Directors provided all requirements for such class of membership are fulfilled.




HONORARY MEMBER
The Board of Directors may from time to time elect as an honorary member a person who has contributed distinguished service to the cause of geology or to the Society.

[ ] Affiliate member ($8.00 annual dues)

DATE: _________ NAME (last, first, middle)______________________________________________

HOME ADDRESS: _________________________________________________________________

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BUSINESS ADDRESS: ______________________________________________________________

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The Geological Society of Iowa will mail the GSI Newsletter to your business address unless otherwise indicated.

Please indicate if you do NOT wish the GSI Newsletter mailed to your business address--------> [___ ]

Undergraduate college or university attended ____________________________________________________

Location ___________________________ Specialization _______________________________

Number of semester/quarter hours in geology _________________ Degree(s)_________________

Location ___________________________ Specialization ________________________________

Degree(s) _____________________________________________________________________

PROFESSIONAL EXPERIENCE:

List in chronological order with current position first. Please include dates, employers, addresses, and major duties or responsibilities.

[---DATE-----------EMPLOYER------------------------ADDRESS-------------------------DUTIES---------]

[_________[_______________________[________________________________[___________________]

[_________[_______________________[________________________________[___________________]

[_________[_______________________[________________________________[___________________]

[_________[_______________________[________________________________[___________________]

[_________[_______________________[________________________________[___________________]

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RELATED EXPERIENCE (Please list interests and activities you do or have done which would contribute to your particiapation in the Geological Society of Iowa.)

(signature of applicant) _______________________________________________________

Mail this conpleted application, with dues to:

Geological Society of Iowa
Secretary-Treasurer
c/o Geological Survey Bureau
109 Trowbridge Hall
Iowa City, IA 52242-1319

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