North American Association of Summer Sessions

Membership Contact Information (print and attach with Membership Application)


Designated (voting) Institutional Representative:
Name: __________________________________________________________
Title:  ___________________________________________________________
Mailing Address: __________________________________________________
                          __________________________________________________
                          __________________________________________________
                          ____________________________Zip/Postal code:______________________
Phone: Area Code (______) Tel.#: ________________ Extension: ________
Fax:      __________________
email address: ___________________________________________________
Web Site:_______________________________________________________

Individual Member or Additional (non-voting) Institutional Member:
Name: __________________________________________________________
Title:  ___________________________________________________________
Mailing Address: __________________________________________________
                          __________________________________________________
                          __________________________________________________
                          ____________________________Zip/Postal code:______________________
Phone: Area Code (______) Tel.#: ________________ Extension: ________
Fax:      __________________
email address: ___________________________________________________
Web Site:_______________________________________________________

Individual Member or Additional (non-voting) Institutional Member:
Name: __________________________________________________________
Title:  ___________________________________________________________
Mailing Address: __________________________________________________
                          __________________________________________________
                          __________________________________________________
                          ____________________________Zip/Postal code:______________________
Phone: Area Code (______) Tel.#: ________________ Extension: ________
Fax:      __________________
email address: ___________________________________________________
Web Site:_______________________________________________________

 

(Duplicate this page as needed for more "Additional Institutional Members")