Société Française de Métallurgie et de Matériaux
Non-profit scientific organization
28, rue Saint Dominique – 75007 PARIS
Tel: +33 1 46 33 08 00 – Fax: +33 1 46 33 08 80 
secretariat@sf2m.fr - www.sf2m.asso.fr	
REGISTRATION FORM 2016
Personal data
Mr.	Ms.	 Dr.	Prof.	NAME : 	First name: 	
Date of birth (dd/mm/yyyy): 			
Business address (University or Company): 

Zip Code (before city name) 	
City	
Zip Code (after city name) 	
Province	
Country or State	
Tel.: 	Fax: 	
Email address: 		Personal address: 

Zip Code (before city name) 	
City	
Zip Code (after city name) 	
Province	
Country or State	
Tel.: 	Mob.: 	
Email address: 		
Address to be used for communication             Business: 	Personal: 	
Annual subscription 

Active Member		120 €
Retired Member		60 €
Reduced fee for "Cercle d’Étude des Métaux" Members		100 €
	
Junior Member 		45 €
(less than 35 years old at January 1st of the year) 
Undergraduate or Graduate student		20 €
(please join copy of student card)	
Reduced rates - Publications
Additional fee for "ASM international" e-membership		30 €
AEM (Advanced Engineering Materials)		120 €
electronic version
IJMR (International Journal of Materials Research) 		575 €	
Matériaux et Techniques electronic version		45 €
Metallurgial Research & Technology		65 €
electronic version
Combined M&T + MRT electronic version		100 €	
Payment

•	Please pay your subscription while returning this form. In a normal year it should be paid before March 31.
•	When payment is made by your organization, please join a copy of this filled form to your internal request: it should be attached to the payment notification sent to SF2M (address above).

•	Credit card : VISA  /  MASTER CARD  /  EURO CARD

Card number   I     I     I     I     I    I     I     I     I     I    I     I     I     I     I    I     I     I     I     I 

Cardholder’s Name : 		Expiration date I    I   I/I    I    I    
On the back of your card, locate the final 3 digit number (card verification number)  I   I   I   I

I undersigned, give the authorisation to SF2M to charge 
my credit card for the total above : 	Euros

Signature :

•	Copy of my bank transfer order 	 Euros to SF2M by fax : +33 1 46 33 08 80
Bank : 	Account : 	

International Bank Account Number (IBAN) : FR76 3006 6101 6100 0103 4140  123
Bank Identification Code (BIC) : CMCIFRPP
(Bank references: Crédit Industriel et Commercial (CIC) - Paris Saint Philippe - 66 rue La Boétie - 75008 Paris

Personal data (continued)

Position:
 Director    Research Director    Associate Director   Head of Department  Head of Service   Engineer  Research Engineer
 Professor  Associate Professor  Assistant Professor   Research Assistant    Others……………….	

Diplomas:
 Doctor degree          Engineering degree	 Bachelor degree 	 Master               Others 	

Honours and decorations : 

 (please specify)
	
Distinctions from Société Française de Métallurgie et de Matériaux : 
	Year
	
Grande Médaille	

	
Médaille Chaudron	

	
Médaille Chevenard	

	
Médaille Portevin	

	
Médaille Bastien Guillet	

	
Médaille Sainte-Claire Deville	

	
Médaille Réaumur	

	
Médaille Charles Eichner	

	
Prix Aperam René Castro	

	
	Year
	
Prix Jean Morlet	

	
Prix Jules Garnier	

	
Prix Mishima	

	
Médaille Jean Rist	

	
Médaille Jacques Pomey	

	
Prix Bodycote-SF2M	

	
Prix Jacques Dalla Torre	

	
Prix ArcelorMittal Pierre Vayssière	

	
Other membership and other scientific distinctions (please specify):
 DGM  member / distinction:…………………………………
 IOM    member / distinction: …………………………………
 SVMT  member / distinction: …………………………………
 AIM    member / distinction: …………………………………
 ASM   member / distinction: …………………………………
 TMS    member / distinction: ………………………………… 
Others (3 max): ………………………………….... ………………………………….………………. ………………………………….. ………………………………….……………………………….
………………………………….. ………………………………….……………………………….