First Name*:
Last Name*:
Position/Title:
Institution:
Institution Address:
Institution Address 2:
Institution City:
Institution State:
New York New Jersey Connecticut Pennsylvania Alabama Alaska Arizona Arkansas California Colorado Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Mexico North Carolina North Dakota Ohio Oklahoma Oregon Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Institution Zip:
Home Address*:
Home Address 2:
Home City*:
Home State*:
New York New Jersey Connecticut Pennsylvania Alabama Alaska Arizona Arkansas California Colorado Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Mexico North Carolina North Dakota Ohio Oklahoma Oregon Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Home Zip*:
Preferred e-mail:
Work Phone:
Home Phone:
Fax:
other:
New member?
Send notices to?
My
directory listing should be ?
I
would be interested in volunteer opportunities with
Other info
we should know regarding your membership:
You
may print and send this completed form with a check for $25 (plus any
additional *tax-deductible donation you would like to make), payable to
the Archivists Round Table of Metropolitan New York, Inc. (ART) to: *
The Archivists Round Table is a 501(c) 3 organization and all contributions
to it are tax-deductible for the donors. Donors have not received any
goods or services from ART in exchange for their donations.
Or push send below to process your
membership online:
ART Membership Form