Membership Form

Download: Membership form

 

Association of Middle East Children and Youth Studies (AMECYS)

Membership Form

 

Personal Information

Salutation:

First Name:

Last Name:

Occupation:

Title:

Discipline:

Affiliation:

Department:

Work Phone:

Cell Phone:

Email:

 

Address Information

For Mailing

Address:

City:

State:

Postal Code:

Country:

 

For Roster (if different)

Address:

City:

State:

Postal Code:

Country:

 

Research Interests

Description (max 50 characters):

 

Payment Link (PayPal)

Annual Membership (select one):  $10 Student Member      $20 Member

Additional contribution (optional): ________

Total Donation: ___________

Submit payment via paypal AND email this completed membership form to: Chiara Diana Chiara.Diana@ulb.ac.be.  (If you are unable or prefer not to remit payment via paypal, please contact Heidi Morrison at hmorrison@uwlax.edu.)

 

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