|
Please use this form if
you are enrolling in the AJS for the first time or if your contact
information has changed.
Print and mail to:
Association for Jewish Studies, 15 West 16th Street, New York, New York
10011.
New_____ Renewal_____
I. Contact Information
Name
____________________________________________________________
Position
__________________Institution_________________________________
Field(s) of
Interest___________________________________________________
Mailing Address_____________________________________________________
Street Apt./P.O.
Box_________________________________________________
City State/Province
Zip/Postal Code______________________________________
Country
__________________________ E-mail __________________________
Telephone
(Office)______________________ (Home)_______________________
Telephone
(Mobile)_____________________ Fax__________________________
Joint* Member
Name________________________________________________
Joint Member
Institution______________ Joint Member E-mail________________
*Joint Membership is open
to couples who share a household and who are both engaged in Jewish Studies. A single membership fee based on combined income is applied.
Both members are included on a single address for mailing.
IF YOU DO NOT WISH TO BE INCLUDED IN THE ONLINE MEMBER DIRECTORY, check here:
______ Do not include my information (name, email, institution, title, areas of research) in the online Member Directory.
II.
Payment Information
2012-2013 Membership Year Dues (September 1,
2012– August 31, 2013)
|