Mail-in Membership Form

 

Name__________________________

Work Address_______________________
City__________________________ State_________Zipcode____________
Country (Other than U.S.)__________________

Home Address_______________________
City__________________________ State_________Zipcode____________
Country (Other than U.S.)__________________

My preferred mailing address is my ____home _____ work address

Daytime Telephone (_____)______________________
E-mail address________________________
Institution_____________________________________
Academic Field and Rank_________________________
Tenured yes no

Please check if you do not wish to include your name on non-AAUP mailing lists.
$_____ National* & Conference Dues
$_____ Chapter Dues

My check (payable to: AAUP) is enclosed for $______
Please charge $______ to Mastercard Visa
Card No._____________________________________________________
Exp. date________________________________
Signature_________________________________________

**National dues may be tax deductible as a charitable contribution except for $30 attributable to Academe. Most conference/chapter dues are not tax deductible. Please consult your lawyer.

Please send your application & dues to: AAUP, P.O. Box 96132, Washington, DC 20077-7020.

If you have questions, please contact Janice Ryan-Arnold.