Organization > Chapters > Great Lakes > Join the Chapter

Membership Form

The 2012 membership form is for the calendar year.

Please select one of the following membership levels:

(**Unemployed level only available for one year.)

Checks should be made payable to the VRA Great Lakes Chapter and sent to:

Astrid Otey, Treasurer
School of Fine Arts
130 Art Building
Miami University
Oxford, OH 45056

Name ______________________________________________________________

Department _________________________________________________________

Institution __________________________________________________________

Address 1 __________________________________________________________

Address 2 __________________________________________________________

City, State, Zip ______________________________________________________

Office Phone ________________________________________________________

E-Mail _____________________________________________________________

I would like to contribute to the VRA Great Lakes Chapter Travel Fund.
Please accept my donation of $______________.

Thank you for your participation in the VRA Great Lakes Chapter.

Please print out this form and mail it along with your 2012 membership dues to Astrid Otey at the address above.

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