Application form

	Yes, I want to become a member of EBBS.
	Personal Data
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	Scientific Information
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	N.B. Students applying for membership should mail or fax a letter from their supervisor to qualify for reduced membership fees to the EBBS treasurer Melly Oitzl, Division of Medical Pharmacology, LACDR, University of Leiden, P.O.Box 9502, 2300 RA Leiden , The Netherlands Fax: +31 71 527 4277 m.oitzl@lacdr.leidenuniv.nl.