COLT: Council on Library/Media Technicians

Council On Library/Media Technicians

MEMBERSHIP APPLICATION
Use this form to join COLT or renew your COLT membership for the current year
COLT membership is for one year from the date your dues are received
:
Name or Institutional Contact Person:
Position:
Institution:
Mailing Address:
Street:
City: State: ZIP
Work Phone: Fax: Home Phone:
E-Mail:
This is my ( ) Home Address ( ) Work Address Membership will be mailed to this address.
TYPE OF MEMBERSHIP (write in appropriate amount)
Personal Membership in United States $45.00 $
Personal Membership outside of United States $70.00 $
Student Membership $35.00 $
Institution Membership in United States
(Indicate official representative on name line of application)		 $70.00 $
Institution Membership outside of United States
(Indicate official representative on name line of application)		 $95.00 $
New ___ Renewal ___ Date________________ Total $

Make money order or check payable to COLT. All payment must be in United States currency.
Mail Application with appropriate dues to:
Membership, Council on Library Media Technicians
PO Box 42048
Mesa AZ 85274-2048
Committee Preference (Check all that apply. Information will be provided to President and Committee Chairs)
Membership _____ Education & Research _____ Public Relations & Publications _____
Constitution _____ Nominations & Elections _____ Conference _____
Discussion List _____ Website _____ Other Interests: _____
COLT Home Page
Comments and suggestions may be sent to the Webmasters of the COLT Home Page
This website is hosted by the Library of the University of California, Riverside,
but all content is the sole responsibility of the maintaining organization.
URL: http://colt.ucr.edu/application.html
Copyright 1997, rev. 2007 Council on Library/Media Technicians, Inc.