Membership Application - International Cytokine & Interferon Society

Emeritus Membership Application

Emeritus Member: Members who have retired or become emeritus of his/her Institution may apply to the Council for admission to emeritus status. Emeritus Members pay a reduced membership fee but shall be entitled to all the rights and privileges of Members.

Membership Dues

One Year
$20.00

Two Year
$35.00

Three Year
$45.00

Membership Dues

Membership Type *

Contact Information Contact Information

Email *

Re-enter your email *

Prefix

First Name *

Middle

Last Name *

Suffix

Title

Informal Name

Institution/Company

Mailing Address *

Address 2 / Department

Address 3

City *

State

Zip Code *

Country

Website

Personal LinkedIn URL

Personal Twitter URL

Personal Facebook URL

Profile Photo

Phone Number *

Fax Number

CCMail

Include me in Membership Directories *
Yes No

Subscribe to our email list *
Yes No

Member Login/Password Member Login/Password

Please enter the Member Login/Password you would like to use to login to this website.

Your Member Login must be unique and must be at least 6 characters.
Passwords must be a minimum of 8 alpha-numeric characters with at least 1 number or 1 letter.

Member Login *

Password *

Confirm Password *

Additional Information Additional Information

Degree Name

If an ICIS member encouraged you to join the society please list their name here

Payment Details Payment Details

Optional Donation to ICIS Student/Postdoc Member Travel Grant Fund to be used to provide additional travel awards to deserving Student/Postdoc members presenting outstanding research at the Annual Meeting to supplement other ICIS Awards. If you wish to make a tax deductible, charitable donation to the ICIS Student/Postdoc Member Travel Grant Fund, please click on a suggested amount below OR add in your own amount in the "Other Donation Amount (Optional) box above your dues amount, this is a one-time donation and will not renew automatically and is OPTIONAL.
Other Donation Amount (Optional)
Amount to Charge :

Payment Method:

Enter the name on the bank account according to the information shown on your bank statement. The account number and routing number can be copied from the lower left corner of the check.

Bank Name:
Bank Account Holder Name:
Routing Number:
Account Number:
Account Type:

Name on Card:

Card #:

Expires:

CSC (What's this?):

PO #:

Enable Automatic Renewals?

Select "Yes" in order to be enrolled in automatic membership renewal. The above payment method will become your saved payment method, overwriting anything that may have been previously saved and will be used for future renewals. You can change the automatic renewal setting or saved payment method at any time in either the "Payment Method" or "Membership Auto-Renewal" tabs where you edit your profile.

No Yes

The International Cytokine & Interferon Society (ICIS) is incorporated as a 501(c)(3) non-profit organization. Dues and subscriptions paid to ICIS are not considered charitable contributions for federal tax purposes. However, they may be deducted as ordinary and necessary business expenses. Members should consult their tax advisors for further guidance. Note that an optional donation to the ICIS Member Travel Grant Fund would be considered a charitable gift (a donation separate from and in addition to your membership dues), and IS tax deductible.