Hawai`i State Chapter of the Society for Neuroscience

Membership Application Form

Please complete and submit the form below to request membership in the Hawai`i State Chapter of the Society for Neuroscience. You are not required to be a member of the national organization in order to be a chapter member. If you choose not to be a member, but would like to be on our email list for seminars and related activities, please email SFN_Webmaster.

Name:
Email:
Web Page:
Status:	Undergraduate StudentGraduate StudentPostdoctoral Fellow StaffJunior ResearcherAssistant ProfessorAssociate ProfessorProfessorTeacherOther	Specify If 'Other':
Laboratory (if not P.I.):
Institutional Affiliation:

A concise (one paragraph) summary of your research/education interests is very helpful. You can 'paste' this in from your preferred word processor.