Membership Form | Women in Cognitive Science

Our goal is to enhance the success of women scientists who are pursuing careers in cognitive science, experimental psychology, and cognitive neuroscience. We are affiliated with the Psychonomic Society.

To join us, please fill out the following form and submit.

Contact Information

First Name: *

Middle Initial:

Last Name: *

Address Line 1: *

Address Line 2:

City: *

State/Province:

Country: *

Zip/Postal Code: *

Office Phone:

Home Phone: *

Fax:

Email: *

Verify Email: *

Affliation

University or Institution: *

Position: *

Education

Highest Degree: *

If Other:

Date of Degree: *

Year: *

Institution: *

Major Field of Study: *

Primary Research Area: *

If Other:

Secondary Research Area:

If Other:

Are you presently a Psychonomic Society member or affiliate? *

Yes

Would you like to volunteer for WICS activities? *

Yes

Not sure

Is this an update of an already submitted membership form? *

By submitting this form, you accept the Mollom privacy policy.