MARCUMS 2019-2020 Membership Information Invoice
This form is for payment by invoice only. Please fill out the requested information to complete your MARCUMS registration. This form should be filled out by all the individuals who will be members. Membership is valid from July 1, 2019 - June 30, 2020.
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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
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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
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MARCUMS Survey
Institution Type
*
Private
Public
Department Type
*
Mail Only
Print Only
Print and Mail
Other
Student Population
*
Employee Population
*
Mail Type
*
Student Mail Only
Bulk Mail Only
Campus Mail Only
Student, Bulk and Campus Mail
Other
Mail Room Type
*
Centralized Student Mail
Resident Hall Mail
Other
Interest in becoming involved in MARCUMS
*
Yes
No
Contact me
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Reference Information
How did you hear about MARCUMS?
*
I am a long standing MARCUMS Member.
MARCUMS Member (Sponsor)
NACUMS Member
Other
Sponsor Name
First Name
Last Name
Sponsor College/University
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Payment
Invoice Information
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( X )
Individual Membership (1)
$
40.00
Institutional Membership (up to 4)
$
70.00
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