POULTRY SCIENCE ASSOCIATION

701 Devonshire Drive, C-51

Champaign, IL 61820
Tel. 217/356-5285
Fax. 217/398-4119
www.poultryscience.org
psa@assochq.org

200346382
MEMBERSHIP ID#: _______________________

Cristian José Cardozo Pascuas

*Name____________________________________________________________________________________________________________

North Carolina State University

*University/Institution _____________________________________________________________________________________________

4108 Lake Wheeler Road

*Address__________________________________________________________________________________________________________

Raleigh NC
*City_________________________________State_______________________________Zip 27603
Code_________________________________

Wake
Country___________________________________________________________________________________________________________

cjcardoz@ncsu.edu 9199312190
*Email______________________________________________________Phone________________________Fax______________________
*Required
Membership dues include electronic access to the Poultry Science journal. Paper copy of the journal is available to members
at the reduced cost of $75.00 with your paid membership dues. Membership term is based on the calendar year, January -
December. The paper copy and electronic access to JAPR is available to PSA members at the reduced rate of $50.00 (quarterly
publication) with your paid membership. Please fill in your selections below:

2019 PSA Graduate Student Dues (includes online PS Journal)* No Charge

2019 PSA Undergraduate Student Dues (includes online PS Journal)* No Charge
Paper Copy of PS journal (surface mail delivery) US$ 75.00
2019 Paper Copy of PS journal (surface mail delivery) International US$ 107.00
2019 JAPR Electronic Access US$ 50.00
2019 JAPR Subscription (surface mail delivery) includes online access US$ 72.00
2019 JAPR Subscription, (International) includes online access US$ 82.00
2019 WPSA-USA Student Membership No Charge
2019 Postdoctorate Dues (includes online PS Journal) US$ 60.00

TOTAL ENCLOSED: $
*FULL TIME STUDENTS: Certification of eligibility is required for Student Members.
Please include a letter that the applicant is a regularly enrolled college student who does not hold a full-time job.

*ADVISOR’S NAME:
Edgar Oviedo
*SIGNATURE OF ADVISOR:
*EMAIL ADDRESS: eooviedo@ncsu.edu

Payment options: Check, VISA, MasterCard, Discover or American Express

Check or Money Order must be made payable in US Funds and drawn on a US Bank.

If paying by credit card, please complete the following:

MasterCard, Visa, American Express, and Discover Card

Credit Card # Exp Date

*Signature

PLEASE NOTE: Credit card payments will appear on your statement as a FASS Online charge.