Revised March 1,998 MEMBERSHIP FORM FOR U.S. ERA'S ENVIRONMENTAL ACCOUNTING PROJECT'S NETWORK DIRECTORY THIS FORM IS FOR NEW AND CURRENT MEMBERS EPA/742/F-.98/016 FAX TO: Kristin Pierre or (202) 260-0178 1. New Member SEND TO: Kristin Pierre, . Environmental Accounting Project (7409) - • U.S. Environmental Protection Agency 401 M Street,'SW Washington, DC 20460 Existing Member Update Remove Member Name 2. Please type or print the following information (For updates please be sure to enter vour name): Name:_ Title: Name of Organization^ Address:. Address: . Phone: Fax: Website:. E-Mail: 3. Please check the appropriate category(ies) (check up to three categories): 'Academic: Research Technical Assistance Curriculum Development Government: Local . '• State ;. Federal 5. Business/Industry Consulting Environmental Public Interest Insurance ;Labor Lending/Financial Services Public Relations Publishing Trade.Association ' Not for Profit: Advocacy Curriculum Development - Research Technical Assistance Other Please describe as you would like it to appear in the Accounting Network Directory and in the space allotted what you do in the areas of environmental cost accounting. 6. Please explain as you would like it to appear in the Network Directory what tools, skills, or services you or your organization can provide to'others: . 7. Additional Information: DQ.NOJ WRITE BELOW THIS LINE ------- ------- |