IRRT Membership Form


Yes, I want to join IRRT*. Enclosed is:

___ USD$15 for Personal ALA Members

___ USD$5 for students

___ Free for International Librarians


APPLICATION FOR IRRT MEMBERSHIP

__________________________________________________________________________
PREFIX                  FIRST NAME              MI                   LAST                SUFFIX

__________________________________________________________________________
JOB TITLE OR CURRENT POSITION

__________________________________________________________________________
IF STUDENT MEMBER, YOUR INSTITUTION

EMPLOYMENT ADDRESS

__________________________________________________________________________
PLACE OF EMPLOYMENT
__________________________________________________________________________

__________________________________________________________________________
STREET

_________________________________________________________
CITY                       STATE/PROV                                  ZIP/PC

_________________________________ ____________________________________
WORK                                    PHONE                                     EMAIL

HOME ADDRESS

__________________________________________________________________________
STREET

_________________________________________________________
CITY                                        STATE/PROV                     ZIP/PC

_________________________________ ____________________________________
HOME PHONE                                      EMAIL (IF DIFFERENT FROM ABOVE)


Send ALA Billing to:  ____ Work  |  ____ Home
Send ALA Mail to:  ____ Work  |  ____ Home

To ensure you receive timely and useful information from ALA units and carefully
screened outside organizations, and that you receive only the types of information you
want, please indicate your communication preferences below:

___ From ALA and outside organizations  ___ Just ALA  ___Official Communications Only

Please choose a format:  ___ By Email  ___ By Paper  ___ Either

PAYMENT METHOD

My check is enclosed for , payable to the American Library Association

Charge to my VISA   |    MasterCard    |  American Express

____________________________________________________________
CARD NUMBER      EXPIRATION DATE   

____________________________________________________________
NAME AS IT APPEARS ON CARD

____________________________________________________________

GO GLOBAL BY JOINING THE IRRT!

 

Mail to:

ALA Membership Services
50 East Huron Street
Chicago, IL 60611-2795 USA