REGISTRATION FOR WORLD DIRECTORY OF 
ARTHROPOD VECTOR RESEARCH AND CONTROL SPECIALISTS

In order to update the Directory, we would appreciate your completing this
form. Please type or print and return it the address listed helow. We would
also appreciate your copying this form and supplying it to any colleagues who
are working in this field. Your cooperation will allow greater communication
and efficiency within our profession.

Name:_______________________________________________________ 
     (Last or family name)     (First or given name) 

Title of present position: 

Nationality:


Present Address:





Telephone (Work):_____________________ (Home):____________________
Fax:___________________ E-mail:_______________________

	DEGREES	DATE	UNIVERSITY






Language(s)
understood:__________________________________________________________

Speciality:

Professional society affiliations: AMCA___; SOVE___; ESA ___;ASTMH___;
RSTMH___;ESC___;_____________________________________________________

Please return by Air Mail to:
Dr. Eugene 3. Gerberg, Chairman, International Affairs Committee, AMCA
5819 NW 57th Way, Gainesville, FL 32653-3257, U.S.A.

Date completed: ________