Institutional Membership Application

2004 Calendar Year

PLEASE CHECK:New Member _______Renewal ________

NAME OF INSTITUTION: _____________________________________________________

NAME OF DESIGNATED REPRESENTATIVE: ___________________________________

ADDRESS:         __________________________________________________________________

__________________________________________________________________

__________________________________________________________________

TELEPHONE: _________________________________FAX: ________________________

EMAIL: _______________________________________URL: ________________________

PERSON MAKING APPLICATION: _____________________________________________

TITLE: _______________________________________________________________________

TELEPHONE: ________________________________FAX: _________________________

EMAIL: ______________________________________URL: _________________________

Please send the completed form, with a check for $50 payable to MAR/AAS, to:

Prof. David C. Prejsnar
Membership Chair, MAR/AAS

Department of History

Community College of Philadelphia

1700 Spring Garden Street

Philadelphia, PA19130

Phone: 215-751-8644/8451

MAR/AAS publications, including the newsletters and the annual conference program, will be sent to the designated representative at the address specified on the application.For additional information please contact David Prejsnar, Chair, Membership Services Committee, Community College of Philadelphia, 215-751-8644/8451, dprejsnar@ccp.edu.

Please advise anyone in your institution with an interest in Asia to apply for individual membership in MAR/AAS. Individual dues are $10; full-time students $5.Membership includes voting privileges, receipt of newsletters and all other MAR/AAS mailings, and an invitation to attend the annual conference. Call 215-751-8644 or 215-751-8547 for information.