Nile Basin Society Membership Application form Please fill in the following information. * Title: Mr. Ms. Mrs. Dr. Prof. * Sex Male Female * First Name * Last Name * Home Address Address 2 * City State/Province Zip * Country * Phone * Email Address Alternate e-mail * Highest education achieved high school college diploma university degree Master of Science (M.Sc.) Ph.D. Discipline/Major * Occupation * Employer * Business Government Non Profit Private sector University Research institute Retired Other Work Address Work web site * Experiences of interest to NBS mission * How can you help NBS achieve its goals? Donate Post to discussion forum Represent NBS in local meetings Represent NBS internationaly Web design System administration Write articles Other, please specify * Country of origin Burundi Canada DR Congo Egypt Ethiopia Eritrea Kenya Rwanda Sudan Tanzania Uganda Other * Do you represent another NGO as NBS affiliate? No Yes, I represent * I had: read and abide to the NBS by-laws and its mission/objectives on its web site understand that I have to inform the NBS administration of changes to my e-mail address and contact information. agree that electronic means are (through e-mail and/or discussion forums) is the method of choice for contact and meetings and I shall do my best to keep these channels open. understand that a membership fee may be required and I shall send the fee (according to by-laws) by money order payable to the Nile Basin Society. Yes, I agree * indicates response required