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|                                 IACMM                                |
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|                      Application for Membership                      |
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| Please complete this application for membership in the               |
| Israel Association for Computational Methods in Mechanics            |
| in Hebrew and English.                                               |
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| Annual fee of 120 NIS (60 NIS for undergraduate students,            |
| soldiers in mandatory service and senior citizens)                   |
| also covers dues to the International Association for Computational  |
| Mechanics (IACM) and a subscription to the IACM Bulletin.            |
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| Please enclose the payment or transfer directly to                   |
| Bank Leumi, Einstein Branch (833), account no. 595585/71.            |
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| Name: ______________________________________                         |
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| ID No.: ____________________________________                         |
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| Position: __________________________________                         |
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| Organization and Address:                                            |
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| ____________________________________________________________________ |
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| ____________________________________________________________________ |
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| ____________________________________________________________________ |
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| ____________________________________________________________________ |
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| ____________________________________________________________________ |
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| Telephone: _________________________________                         |
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| Fax: _______________________________________                         |
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| E-mail: ____________________________________                         |
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| Technical Interests:                                                 |
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| ____________________________________________________________________ |
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| ____________________________________________________________________ |
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| Send completed form and dues to:                                     |
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|   Emanuel Ore                                                        |
|   RAFAEL                                                             |
|   Dept. 39850                                                        |
|   P.O. Box 2250, Haifa, ISRAEL                                       |
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|   tel: +972-4/990-8640, fax: +972-4/990-8164                         |
|   e-mail: Emanuelo@rafael.co.il                                      |
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