MABSA Membership Application

Name

Certification/Licenses

Degree(s)

Title/Position

Company/Organization

Address

Telephone

Fax

Email Address

Referred by

Individual Membership $20.00  

MABSA is open to all individuals interested in biosafety. If you wish to be a member, please complete this application by providing the information requested, as you would like it to appear in the membership directory.
Print the application and send with a check for $20.00 payable to MABSA, to the treasurer:
 

Kim Main Heard

Yale University

135 College Street, Suite 100

New Haven, CT 06510

kimberly.heard@yale.edu