ISCAR Membership Payment by Credit Card

I am a member of the International Society for Cultural and Activity Research (ISCAR).
I want to make my ISCAR membership contribution through the calendar year

Name_________________________________________________________
Address_________________________________________________________
City (State)______________________________Postal Code_____________
Country__________________________________________________________
Telephone Number_______________________________________
Email__________________________________________________
Card Type: Visa Logo Mastercard Logo American Express Logo JCB Logo
Card number: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Valid until:
Amount :
Note! Your credit card will be charged an equivalent amount in Danish crowns (DKK), using the exchange rate given by Danmarks Nationalbank at the time your card is charged.
Signature___________________________________________________________
Date_______________________________
Send form by post to: ISCAR Secretariat, c/o Emily Merko, Department of Education, University of Bath, Bath BA2 7AY, United Kingdom by fax to: +44 1225 38 6113