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International Society for
Quality of Life Research
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| Executive Office |
| 6728 Old McLean Village Dr. |
Fax: (703) 556-8729 |
| McLean, VA 22101-3906 USA |
Email: info@isoqol.org |
| Telephone: (703) 556-9222 |
www.isoqol.org |
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2008 INDIVIDUAL MEMBERSHIP
APPLICATION
January 1 - December 31
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| Please type or print clearly: |
| NAME:_________________________________________ Degree(s):__________________ Male ___ Female ___ |
| Job Title:____________________________________________________________________________________ |
| Institutional Affiliation / Company Name:____________________________________________________________ |
| Mailing Address:______________________________________________________________________________ |
| City____________________________ State___________ Zip Code____________ Country__________________ |
| Telephone:______________________________________ Fax:________________________________________ |
| E-MAIL ADDRESS:____________________________________________________________________________ |
| Website:____________________________________________________________________________________ |
| Survey Data: |
| Discipline: |
 Academia Clinical Government Industry Other (specify) __________________ |
| Interests: |
Medicine Statistics Epidemiology Sociology Psychology Economics
Nursing Pharmacology Other (specify) __________________ |
| Primary Interests in QOL research: |
________________________________________________________________________ |
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MEMBERSHIP FEES: (Choose one type of membership)
Regular
(professionals in the field) - $119 US
Contributing
(suppliers/supporters) - $226 US
Student*
(pre-doc, post-doc, resident, fellow) - $49 US
Retired
- $49 US
Special
(income of $15,000 US or less, annually) - $38 US
Institutional Membership (See Institutional Membership Application)
*Please submit proof of student status
MEMBERSHIP DIRECTORY:
Please check here if you do NOT give permission to the Society to print your name and contact information in our directory, which will be published on our website, accessible only by our other
members with an active password.
Please
check here if you do NOT give permission to ISOQOL to include your name in
the lease of mailing labels to other organizations.
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PAYMENT OPTIONS:
(PLEASE SUBMIT THIS FORM WITH PAYMENT.)
OPTION I: CHECK OR MONEY ORDER
(IN US FUNDS PAYABLE TO ISOQOL)
OPTION 2: CREDIT CARD (VISA OR MASTERCARD)
Credit Card Number:
________-_________-________-_________
Expiration Date: ___________
Signature:____________________________
Please send completed form and payment to:
ISOQOL Executive Office, 6728 Old McLean Village Drive, McLean, VA 22101-3906, USA
or FAX: 703/556-8729.
Processing of your credit card may take up to four weeks. If you need immediate processing, please contact ISOQOL at info@isoqol.org.
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SPECIAL INTEREST GROUPS:
Listings of the SIGs are located below. Please indicate which SIG(s)
you would like to join by noting the alphabetic
code of the SIG(s):
___________________________________________________________________________
Are you interested in becoming a group leader of any of these SIGs and
if so, which one(s)?: ___________________________________________________________________________ |
MEMBER SUBSCRIPTION OFFER FOR QOL Journal:
Your membership includes a complimentary online subscription to the Quality of Life Research journal.
Do you want to receive a discounted hard copy subscription to the QOL Research Journal at $60 per year? ___Yes ___No
If yes, please include payment for the subscription with your dues
Take advantage and keep in touch!
Please indicate if you would like to subscribe to an ISOQOL listserv containing
general information about ISOQOL and QOL related discussion i.e. favorite articles,
collaboration, getting advice, etc.
Yes, sign me up!
Not at this time.
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Special Interest Groups
As a member benefit, ISOQOL has organized Special Interest Groups (SIGs). Sign up for as many groups as you would like and if interested, offer to be a group leader to help with the facilitation and ongoing communication with a particular SIG. Please indicate your selection above.
A. Clinical Significance/Interpretation
B. Cross-Cultural Research/Translation Methods
C. HIV/AIDS
D. IRT/Psychometric Methods
G. Response Shift
H. Statistical Methods
I. Utility Measures
J. SEIQoL (Schedule for the Evaluation of Individual
L. QoL in Clinical Practice
M. New Investigators
N. Cultural Adaptation
O. QoL in Ibero-America
P. KIDS: QoL Assessment in Children & Adolescence
Q. Mental Health |
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