Antrag auf Mitgliedschaft
in der Zoological Society Wallacea (ZSW):
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Name / Name
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Institute, Abteilung / Institution, Section
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Straße / Street
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PLZ und Ort / City code and city
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Land / country
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Tel./Fax / phone / fax-No. Email:
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Interessengebiete , Region / special interest, region
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
__________________________ _______________________________________
Geburtstag / date of birth Beruf / profession
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Datum & Ort / date and place
Antargsformulare an / membership applications to:
Zoological Society Wallacea
Ulf Buchsbaum
Zoologische Staatssammlung München
D - 81 247 Mücnhen
Germany
Fax:+ 49 / (0)89 / 81 07 300