MARCUMS 2019-2020 Membership Information

MARCUMS 2019-2020 Membership Information

This form is for online payment only. Please fill out the requested information to complete your MARCUMS registration. This form should only be filled out by the individual making payment for the individual or institutional membership. Additional members under an institutional membership should fill out the "Pay by Invoice" form. Membership is valid from July 1, 2019 - June 30, 2020.

Membership
Membership Type *

Individual Membership $40 (1) Institutional Membership $70 (up to 4 members)
Renewal Type *

Renewal New Member from a Renewing Institution New Member from a New Institution
How would you prefer to receive your MARCUMS Newsletter? *

Digital - PDF through Email Hard Copy - USPS First Class

Contact Information
Name *

First Name Last Name
College/University Name *
Department *
Job Title *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Work Phone Number *

Area Code Phone Number
Fax Phone Number

Area Code Phone Number
Cell Phone Number

Area Code Phone Number
Alternate Email
example@example.com

Reference Information
How did you hear about MARCUMS? *

I am a long standing MARCUMS Member. MARCUMS Member (Sponsor) NACUMS Member
Sponsor Name

First Name Last Name
Sponsor College/University

Payment
Membership Credit Card Payment *
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Individual Membership (1) $ 40.00

Institutional Membership (up to 4) $ 70.00
Subtotal $ 0.00 Shipping $ 0.00 Total $ 0.00
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