Membership Registration Form
Date: __________________________
Note: LAMA's membership year runs from December 1 through November 30.
Name and address:
Telephone number:
E-mail address:
Please check the level of membership:
Initial membership
Renewal
| Student | $5.00 | |
| Individual | $15.00 | |
| Senior Citizen | $10.00 | |
| Family (2 members; plus $5.00 for each additional adult member) Please give name and contact information for each member | $20.00 | |
| Organizational (2 members; plus $10.00 for each additional staff member) Please give name and contact information for each member | $30.00 | |
| Sustaining | $50.00 | |
| Patron | $100.00 | |
| Life | $1000.00 |
Mail form along with a check or money order payable to LAMA, to the
following address:
Bruce Turner
Treasurer
University of Louisiana at Lafayette
P. O. Box 40199
Lafayette, LA 70504
bturner@louisiana.edu