NAHSL Online Membership Application (for calendar year 2012)
Please use this form for Membership Payments using PayPal

To join or renew by check go to: NAHSL Membership Application (PDF)

Name:

Library/Institution:

Address:

City: State: Zip:

Business Phone:

Fax:

E-mail:
Membership renewals MUST be paid by March 15, 2012
to qualify for reduced Conference rates and Scholarships!

Annual Dues are $30.00 for Regular Members.

NOTE: Membership renewals MUST be paid by March 15, 2012 to qualify for reduced Annual Meeting registration rates, for Professional Development Scholarships, and for Technology Grants. If your institution provides money for NAHSL membership it is your responsibility to make sure that the check meets the March 15 deadline.

Please make checks payable to NAHSL and mail with this form to:

NAHSL Membership Chair:
Valori Ann Banfi
c/o NAHSL
102 Wetherell Street
Unit #9
Manchester, CT    06040


Please Note: This is a new address. You may need to notify your institution of the address change.

Membership is for twelve months, beginning in January 2012. Please indicate your membership category:

$30.00 for Regular Membership paid by credit card using PayPal.™

What committee(s) are you interested in serving on?

Archives
Bylaws
Education
Electronic Communication
 Finance
Government Relations
Marketing
Membership
Program

Check all that apply:

    New Member
    Renewal
    MLA Personal Member
    MLA Institutional Member

Academy of Health Information Professionals (AHIP)
If you are an AHIP member, please select the appropriate level:

AHIP Provisional Member
AHIP Member
AHIP Senior Member
AHIP Distinguished Member
AHIP Emeritus Member

 


Please make checks payable to NAHSL and mail to:

NAHSL Membership Chair:

Valori Ann Banfi
c/o NAHSL
102 Wetherell Street
Unit #9
Manchester, CT 06040
valori.banfi@uconn.edu

To join or renew by check use the NAHSL Membership Application (PDF)

 

 

This page last updated December 29, 2010

 

 

 

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