ina dues statement 2015

INA International Neurotoxicology Association
(http://www.neurotoxicology.org)
DUES 2015 PAYMENT
Please use statement (form) in last page
Dear INA Member,
It is time for collecting the INA dues. Please note your dues are for a one year period from
2015/01/01 through 2015/12/31
The INA dues are as low as 25 euro per year. Dues can only be paid in Euros to the INA account in
the Netherlands, either by direct bank transfer or by using PayPal for direct money transfer to the
PayPal account of INA. By paying your dues you contribute to the success of INA in reaching its
goals, in particular providing travel support for students to attend INA meetings. You also get several
advantages, including a reduced fee at the forthcoming INA meetings.
Current student members who have graduated should pay dues to become full members, or should
send a proof of studentship to the Secretary at the address below to renew their student status.
Members that are unable to pay their dues for whatever reason, but that still want to be INA
members, should send a letter stating so, also to the Secretary.
INA encourages members to pay their dues using PayPal.
INA dues can also be paid by Direct Bank Transfer (wire transfer).
Please, see details below in the INA MEMBERSHIP DUES STATEMENT
You are requested to pay the charges for the transfer, so INA receives the full 25 Euro. As these
charges can be quite high, you are allowed to include in a single transfer the dues from several INA
members. The dues form and copy of your payment must be sent to the Treasurer, Jan Lammers, at
the address below. Please, note that the name of the paying member is sometimes not accessible from
the transfer, so your payment may not be recognized if you fail to send its proof to Jan Lammers.
If you have questions, contact Jan Lammers or Sandra Allen:
INA Treasurer
Jan H.C.M. Lammers, PhD
International Neurotoxicology Association,
Gildenring 11, 3981 JD Bunnik,
The Netherlands
Tel.: +31 612 55 3243
[email protected]
INA Secretary
Sandra Allen, PhD
Regulatory Science Associates
Oliander House, Main Street, Hougham,
Grantham, Lincolnshire, UK
Tel: +44 1400 250 825, Fax: +44 1400 250 825
[email protected]
(Continue next page)
INA MEMBERSHIP 2015 DUES STATEMENT
Deadline: December 31, 2015
Please note your dues are for a one-year period
Please check one:
I wish to remain a member of INA and will pay my dues as indicated below
I do not wish to remain a member of INA
I will pay my dues by:
Direct transfer to the PayPal account of INA (25 Euros)
The e-mail address for the INA account is [email protected]
Direct Bank Transfer (wire transfer) of 25 Euros
(please include bank carrying charges or porto costs) to:
- bank account number: 518899896
- name: International Neurotoxicology Association, Bunnik, The Netherlands
- bank: ABN AMRO Bank, Driebergen, The Netherlands
- SWIFT code: ABNANL2A
- IBAN number: NL34ABNA0518899896
Please send this completed form to:
Jan H.C.M. Lammers, Ph.D.
International Neurotoxicology Association
Gildenring 11,
3981 JD Bunnik,
The Netherlands
or send a copy (pdf format) by e-mail to:
[email protected]
Notes:
 You must send this form, otherwise your PayPal payment or Bank Transfer may not be
recorded in your name.
 Please print or type the following information:
Name:
Title:
Institution:
Address
e-mail:
Signature:
date
INA is registered as a non-profit society at the Chamber of Commerce "KvK Rijnland" in Leiden, The
Netherlands, under dossier nr. 28094562

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