CSRA Library Association


Application Form - 2000/2001
Check the appropriate box:
New Membership:    [  ]
Renewal Membership:    [  ]
 
NAME _________________________________________________________________________

ADDRESS ______________________________________________________________________

CITY/STATE ____________________________________________________ZIP ____________

_______Check if new address

HOME PHONE _________________________________________________________________

LIBRARY NAME _______________________________________________________________

POSITION _____________________________________________________________________

WORK PHONE ___________________________ FAX NUMBER _______________________

EMAIL ADDRESS ______________________________________________________________
 
[  ]    I do not want my name listed in the web membership directory of the CSRA Library Association.
[  ]    Please mail me a copy of the CSRA Library Association Newsletter - From the Bookshelf.


The membership year in the Association runs June 1 through May 31. Annual dues are $5.00,  $3.00 of which goes to the Elizabeth M. Tyson Memorial Grant.

Please send this form along with a check (payable to CSRA Library Association ) to:

Fay Verburg
Reese Library
Augusta State University
2500 Walton Way
Augusta, GA  30904
(706) 667-4906

Return to the CSRA Library Association Webpage