Membership
Category (check one)
Individual ($35) Student ($15) Institutional ($120) Life ($300) Retiree ($15)
For
institutional membership, please attach as listing of up to
four persons who will be part of this membership.
Name:
Title:
Organization:
Organization
Address:
City:
State:
Zip code:
Phone:
Fax:
E-Mail:
Are
there areas of expertise you would be willing to share with
other MVAEA members? If so, please list for inclusion
in Network Directory of MVAEA membership. (Please note:
All arrangements for resource sharing - including
compensation - are the responsibility of contracting MVAEA
members.)
You
can either print out this form by clicking on File | Print
| Ok or you can click on the submit button below and send
your check to:
Dale Amunson
Acting Membership Services Consultant
P.O. BOX 36
503 S. Mather St.
Clarksville, IA 50619
319-278-4747 daleaa@butler-bremer.com
