I wish to be considered for an award from the K. J. Fox Memorial Fund to attend the annual confference of the Entomological Society of New Zealand conference. I am a non-funded member of the society and therefore make the following Declaration:


I hereby declare that I receive no wages, salary or fees for carrying out investigations into the science of entomology or related disciplines.

 

Signed..................................................................                                           Date......................

To be eligible for an award, your form must be returned to:

Pauline Syrett
Secretary
Entomological Society of New Zealand
Bioprotection and Ecology Division
PO Box 84
Lincoln University 7647
Canterbury
New Zealand