IAGLR 2008 Membership Application

Use this form if you are paying with Visa or MasterCard and would like to submit your application securely online. We've set up an account with VeriSign, a leader in authentication and payment services, to provide secure transactions for online credit card submissions. We encourage you to take advantage of this convenient and secure method of payment. If you'd prefer to mail or fax your application, please use our mail/fax form.

Please allow up to five business days for your membership to be processed. An electronic membership card will be sent directly from the IAGLR Business Office indicating your 2008 status has been activated.

Contact Information
Name
Business Address
Company/Organization Name
Address
City
State or Province
Postal/Zip Code
Country
Work Phone
Home Phone
Fax
E-mail
(We will send a receipt to this address.)
Mailing Address (if different)
Address 1
Address 2
City
State or Province
Postal/Zip Code
Country
Type of Membership
Print*Electronic**Electronic & Print***
Individual
Regular $130 $130 $165
Student $35 $130 $165
Young Professional $65 $130 $165
Retiree $65 $130 $165
Life n/a n/a $2475 one-time fee
Corporate/Institutional
Library/Institution $300 $400 $450
Sustaining $1500 n/a $1650
*Includes full membership benefits and printed Journal of Great Lakes Research subscription.
**Includes full membership benefits, electronic Journal of Great Lakes Research subscription, and access to the online JGLR archive database.
***Includes full membership benefits, both the printed and electronic JGLR subscription, with access to the online JGLR archive database.
For more information about electronic subscriptions, please review the Terms and Conditions for individual subscribers and the Site License Agreement (90KB PDF) for institutional subscribers.
Year of Membership
Memberships follow the calendar year, January through December. Your application will be applied to 2008.
JGLR back issues available. Please contact me.
Background Information
Highest Academic Degree
Year
Institution
Degree Specialty
Current Research Interests
(In order of preference)		1.
2.
3.
Professional Title
Association Contribution *
I'd like my contribution to support the following: Amount
Paul W. Rodgers Scholarship Fund$ 
IAGLR Conference Student Travel Awards$ 
IAGLR Endowment Fund$ 
IAGLR Scholarship Fund$ 
IAGLR Library Donor Fund$ 
No preference, general contribution$ 
JGLR Donor Program (optional)
I do not wish to receive my journals; please donate them to a needy library.
I wish to sponsor a library for $300 U.S.
I wish to nominate the following library to the IAGLR Library Donor Program: (Provide complete name & address of nominee)

* IAGLR is a U.S. non-profit 501(c)(3) organization. Donations are deductible from U.S. income tax and deductible against U.S. earnings in Canada. IAGLR is also a Canadian non-profit organization with charitable status pending.