Registration for Φ·SOE Membership

The following information is only for internal use of the Φ·SOE within the DPG (German Physical Society). The DPG receives a message about your registration for the member support as they keep a record of all Φ·SOE members too.

Please note that fields marked with * are obligatory.

You can choose whether your data will be visible in the online List of Φ·SOE Members. Telephone and fax numbers will not be displayed.

Title:
First Name: *
Last Name: *
DPG membership number: *	(You need DPG membership. To become a DPG member, please sign up here.)
Display in List of Φ·SOE Members: *	(Telephone and fax numbers will not be shown.)
Institution: *
Street: *
Zip Code, City: *
Country: *
Telephone:
Fax:
E-mail: *
Homepage (Universities and Non-Commercial Institutions only!):
Fields of interest (maximum of 4 rows): *
Comments/Requests: (e.g. address change)
	Please type the text of the graphics to prevent the form to be abused by spam bots etc.