Membership Form
Please print this out, fill it out, and mail it in.
May 2013 – May 2014
New Membership
Membership Renewal
Student Membership
Retired and independent scholar membership
Charter Membership
Donation
Name: ___________________________________________________________
last first middle
Institutional Affiliation: ______________________________________________
Department: ______________________________________________________
Institutional Address: _______________________________________________
City: ______________________ State: ____________________
Zip: _____________ Country___________________
Telephone (work): ___________________ (home): _____________________
E-mail Address: _______________________________
Fax number: _____________________________
Areas of interest related to AALCS:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Annual Membership:
Regular $25.00; Graduate Students: $15.00; Retired and independent scholars, $15, charter membership $250.00.
Please write your check or money order to:
African American Literature and Culture Society
and send to the Secretary/Treasurer:
Keith Byerman
Professor of English and Women's Studies
Indiana State University
Terre Haute, IN 47809
