DECLARATION OF MEMBERSHIP OF THE POLISH TRIBOLOGY SOCIETY

I the undersigned, after becoming familiar with the statute, declare the will of the membership of the Polish Tribology Society

Name and surname:

Academic degree :

Date and place of birth:

Home address :

Telephone (home) :

E-mail :

Affiliation / Company :

Position :

Proffesional specialisation:

Office address :

Telephone (office):

Fax :

E-mail :

.................. Place	.................. Date	....................... Signature
The membership fee of 30 PLN for the year 20..... and the registration fee of 2 PLN have been collected.
	..................................... Treasurer