EUROPEAN CLUB MEMBERSHIP REGISTRATION

One-time Membership Fee: $10

You can fill out this form in a text editor and e-mail it to
"join@euroclub.mit.edu".

Please use our credit card payment system at 
http://shopmit.mit.edu/stores7.0/euroclub/page2.html
to pay the membership fee.

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Name:

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(first)                 (last)

Local Address:

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(number and street)                (apartment or room number)

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(city)                          (state)                 (zip)

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(home phone)

If this is an MIT dormitory, which one (eg. Tang, Next House)?

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Office room number (only if at MIT):

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Work phone:

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e-mail:

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Home country:

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Department or field of study or research:
(This should be the general area you are working in, e.g. "Physics", not
"Theoretical condensed-matter physics".)

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University/Institution/Company:

___________________________

Since when are you at MIT (or in the Boston area)? (mm/yy)

__________

Until when will you be at MIT (or in the Boston area)? (mm/yy)

__________

The answers to the following questions will be used for statistical
purposes only, and will not be made public.

Status at MIT:
   ___Undergraduate student
   ___Graduate student
   ___PostDoc
   ___Visiting student/scientist/scholar
   ___Other at MIT
   ___MIT alumnus/a
   ___Not at MIT

Please check which activities you are interested in:
   ___On-campus events (parties, receptions, BBQs)
   ___Cultural events (concert visits, museum visits)
   ___Pub tours
   ___Talks on current affairs
   ___Bicycling tours
   ___Hiking trips
   ___Whitewater rafting trips
   ___Downhill skiing trips
   ___Cross-country skiing trips
   ___City tours (New York, Montrial)
   ___Soccer
   ___Volleyball
   ___Ice hockey
   ___Sailing

Suggestions for other activities of the European Club (including sports
other than those listed above):

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For more info about the club check out our web page at:
http://euroclub.mit.edu