Membership – Waresa

MEMBERSHIP REGISTRATION FORM

For membership types and fees, click here

Choose Individual membership or Institution membership *

Prefix

First Name *

Middle Name

Last Name *

Email Address *

Phone

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country *

BirthDay *

Month

Day

Year

Select Country of Origin (choose "Others" if not available) *

Select Continent of residence (Choose "Others" if not available) *

Select Country of residence (Choose "Others" if not available) *

Select Your current status (Choose "Others" if not available) *

More details about your status (Ex IT Engineer at Microsoft and Part time Ms Student at University of Chicago, USA or Associate Professor, Department of Law, Universite de Nantes, France) *

Name and location of the institution *

Type of institution *

More details about the institution *

How did you know about WARESA *WebsiteSocial MediaFriendOthersChoose 1 or more