S M A T C H

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You can join SMATCH and participate in our projects.

Print and send this form to one of the addresses below, or send e-mail to sjehrman@msn.com with "SMATCH membership" in the subject line.

Largo Ugo Bartolomei 5
00136 Roma
Italy
Tel: 39 06 3972-5461
sjehrman@libero.it 612 Woodside Parkway
Silver Spring MD 20910
U.S.A.
Tel: 001 301 565-9484
sjehrman@msn.com

Scientific Methodologies Applied to Cultural Heritage, Inc.
Membership application

First Name:

Last Name:

Home address:

Home phone:

Home eMail:

Business or Professional Address:

Business/Professional phone:

Business/Professional eMail:

Business/Professional fax:

Fields of Interest:

What SMATCH activities or programs may be of interest to you?

Would you like to volunteer in any activity field?

Would you like to chair a specific program?

Signature:
Date:

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First Name:	Last Name:
Home address:
Home phone:	Home eMail:
Business or Professional Address:
Business/Professional phone:	Business/Professional eMail:
Business/Professional fax:
Fields of Interest:
What SMATCH activities or programs may be of interest to you?
Would you like to volunteer in any activity field?
Would you like to chair a specific program?
Signature:	Date: