Copy-and-paste the following into your word processor, then print out the form.  Fill out the form and then fax or mail it to the address found at the end of the form.

Membership Fees

Membership fees structure (fees in Euros)

Student Membership: Student Membership is for one year. Student Identification is required. Euro 15.00

Student Membership Special Offer The Student Membership Special Offer is for one year Euro 35.00 BUT we give you two additional consecutive years for free with this offer.

Regular Membership: Regular Membership is for one year Euro 40.00

Regular Membership Special Offer: Regular Membership Special Offer is for one year Euro 100.00 BUT we give you two additional consecutive years for free with this offer.

Institutional Membership: Institutional Membership Special Offer is for one year Euro 100,00 BUT we give you two additional consecutive years for free with this offer.

For Life Membership, please inquire per email to the Treasurer, Prof. Dr. Gerd Ferdinand Kirchhoff, email gerd@tokiwa.ac.jp



Membership Application Form 

Print out and mail or fax to the Treasurer

Name_________________________________

Title and Organization _____________________________

Address

_____________________________________

_____________________________________

_____________________________________

Telephone: ________________________________ 

Fax: _______________________________

Email: __________________________________

I agree that this information is included in the 
Membership Directory (online or hardcopy)
	( ) yes 
	( ) no
	
The WSV maintains an e-mail listserv through which messages 
about WSV events, announcements from the Executive committee, and 
others WSV news items are broadcast to our membership.  
I wish to be subscribed to this e-mail listserv at my e-mail address
listed above:
	( ) yes 
	( ) no

Primary Activity (Check all that apply)
	( ) Academic 
	( ) Victim Assistance 
	( ) Government 
	( ) Volunteer 
	( ) Research 
	Other:_________

Membership Types: 
	( ) Regular 
	( ) Regular, Special Offer
	( ) Student
	( ) Student Special Offer
	( ) Institutional Special Offer
	( ) Life (Contact Treasurer)


Payment process
Select your payment method below. You can pay: via credit card through our secure payment system, or via banking transfer.  In all cases, send a copy of this completed membership application to the Treasurer:

1. You can purchase your membership online via credit card, using the WSV's secure system, via WorldPay's credit card processing system.  Go to: http://www.worldsocietyofvictimology.org/payment.html
Select the membership type you wish (remembering you must meet the critera for the membership type selected), and click "Buy".  You will be taken to WorldPay's secure credit card processing system where you can enter your payment information.

Please note:  Upon successful payment you will receive an email with your Transaction Number.  Please include the Transaction Number below when you submit your application, so we can confirm your registration with the appropriate membership type:

WorldPay Transaction Number: _____________________

or

2. Bank transfer payment in Euros to: 

	Bank: Gladbacher Bank AG
	Mönchengladbach, Germany
	Bank code: 310 601 81
	Account: 5084737013
	BIC: GENO DE D1 GBM
	IBAN: DE59 3106 0181 5084 7370 13

(Remember to send this application form 
separately to the Treasurer)



Signature: ____________________________________________________


The Treasurer is authorized to reduce fees for applicants from countries designated low income by the United Nations. For more information, communicate with the Treasurer
   
Kirchhoff, Gerd Ferdinand, Prof. Dr. jur.
Professor of Victimology,
Tokiwa International Victimology Institute
Graduate School of Victimology  
Tokiwa University
1-430-1 Miwa,
3108585 Mito
Japan
Phone: +81-29-232-2796
Fax: +81-29-232-2522
gerd@tokiwa.ac.jp