Contact Webmaster jhaley@bsu.edu * Last updated 5/23/2008
Original website design 11/01/2006 by Jennifer Haley
membership application
Last Name: First Name:
Middle Initial: Institution:
Street Address (line 1): (line 2)
City: State: Zip:
Daytime Phone: (Enter xxx-xxx-xxxx with no parenthesis)
Evening Phone: E-Mail Address:
Fax Number: Membership Type: Regular Student Retiree TLAR only
Renewal or New Member? Renewal New Member Have you earned LCLC? No LCLC Level 1 Level 2 Level 3 Level 4
Are you interested in serving on a committee? Professional Development Newsletter Finance Conference Membership Nominations None at this time
Payment Option (please check one):
I will send payment through the mail:
I will pay through PayPal (PayPal button is on the Membership page):
The Membership Secretary Tammy Pratt will contact you within one week of receiving and applications AND dues payment.
You must click "Submit" to submit this application.