|
Subscription/Membership
Application Form
Contact - First
& Last Name:----------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
Institution/University
Address:---------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
Mailing Address:---------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
Telephone:………………………….Fax:………………………………...
Email:------------------------------------------------------------------------------------------------
This application
is for (check only one):
____Individual
Biannual Subscription to SORAC JAS……………US $ 40
____Institutional
Biannual Subscription to SORAC JAS…………..US $80
____Membership in
SORAC (includes one SORAC JAS issue) $50/Year
____Membership in
SORAC (Students).. . US $30/Year
Amount Paid: US
$_______
Comments:
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------
US Residents:
pay by US check, or money order made payable to SORAC/MSU.
If you are
abroad, pay by international money order made payable to SORAC/MSU.
If paying via Western Union, make sure the money is delivered to: Dr.
Daniel Mengara.
Mail form and payment to: Dr. Daniel Mengara, SORAC, Department of
French, German, and Russian, Montclair State University, 1 Normal
Avenue, Upper Montclair, New Jersey 07043, USA. |