Manual Entry

If you would like to be included in the "Directory of Parasitologists in Canada", please fill in the entire form below. If you want to change some of the information that is currently listed, please fill in your name and the new information only. Use the "Print Preview" function of your browser to verify that it will print properly. You may have to set your browser to display a smaller type size, e.g.10-12 point type. Then print this page from your web browser and send by snail mail to address at bottom.

Personal Information

Name (REQUIRED)
format: LAST, First
Address
City
Province
Postal Code
Position
Highest degree attained
Phone:
format (123) 456-7890
phone extension, if any:
Fax:
format (123) 456-7890
E-mail
Affiliations

Research

Interests

Briefly describe your research interests and projects:

Parasites

What taxonomic groups of parasite are you currently interested in? Check all that apply. (Hold down the "control" key while making multiple selections.)

If you selected "OTHER" above, please specify:

Host groups

Which host groups are you currently interested in? Check all that apply. (Hold down the "control" key while making multiple selections.)

If you selected "OTHER" above, please specify:

Themes

Which of the following themes best describe your research interests? Check all that apply. (Hold down the "control" key while making multiple selections.)

If you selected "OTHER" above, please specify:

Permissions

Do you grant the right for commercial use of your e-mail or other addresses obtained from this list? Select one of the following.


Send completed form to:

Dr. Al Shostak

Deptartment of Biological Sciences

University of Alberta

Edmonton, Alberta T6G 2E9