ݺߣ

ݺߣShare a Scribd company logo

Solicitud para la renovación o ingreso a Reforma Capítulo de Puerto Rico

•
•
R
Reforma P.R.

This document is a membership application for REFORMA. It provides instructions to join online or mail in the completed application with payment. It requests contact information and payment details. Membership levels and annual dues are listed for different types of members including individuals, students, libraries, and organizations. Chapter affiliations are listed if the member wishes to be affiliated with a local chapter.

1 of 1
Download to read offline
Membership Application Join online: www.reforma.org/join Mail completed application and payment to: REFORMA P.O. Box 832 Anaheim, CA 92815‐0832 Chapter Affiliation Payment Dr. Mr. Mrs.  Ms. First Name Street City Email LIFETIME Membership .................................. $450.00 Librarian Earning >$60k/year .........................  $50.00  Librarian Earning $30‐59k/year ......................  $40.00  Librarian Earning <$30k/year .........................  $35.00  Library Trustee/Commissioner .......................  $30.00  Library Support Staff .......................................  $25.00  Author/Supporter/Retiree ..............................  $25.00  Library Science Student ...................................  $10.00  New Renewal Phone State Zip/Postal Code Country Middle Name Last Name Yes  Yes Share Email?  REFORMA will occasionally rent its member’s email and/or  mailing address to approved vendors and/or organizations. Membership Dues Total: TOTAL PAYMENT ENCLOSED: payable to REFORMA Scholarship Donation Total: payable to REFORMA Scholarship Fund Member‐at‐Large (No Chapter Affiliation)  INDIVIDUAL INSTITUTIONAL Corporation/Publisher ................................... $250.00 Library/Library School .....................................  $100.00  Non‐Profit Organization ..................................  $100.00  Bibliotecas para la Gente (San Francisco, CA) California Gold (Sacramento, CA)  Central Arizona  Colorado  El Corazón de Tejas (Austin, TX)  El Paso  La Estrella de Tejas (San Antonio, TX) Florida Libros (San Diego, CA)  Los Angeles  Midwest (IL, IN, WI)  New Mexico  Northeast (PA, NJ, NY, CT, RI, MA) Orange County (CA) Oregon Puerto Rico  Rio Trinidad (Dallas/Ft.Worth, TX)  Tucson Washington  No  No Please complete all sections of this application Member Information International Member .......................................  FREE Membership Annual Dues Academic Public Special School Other If you work in a library, please specify the type of Library: Share Mailing Address? Last updated: 5/14/2015 $ 0.00 $ 0.00

More Related Content

Solicitud para la renovación o ingreso a Reforma Capítulo de Puerto Rico

  • 1. Membership Application Join online: www.reforma.org/join Mail completed application and payment to: REFORMA P.O. Box 832 Anaheim, CA 92815‐0832 Chapter Affiliation Payment Dr. Mr. Mrs.  Ms. First Name Street City Email LIFETIME Membership .................................. $450.00 Librarian Earning >$60k/year .........................  $50.00  Librarian Earning $30‐59k/year ......................  $40.00  Librarian Earning <$30k/year .........................  $35.00  Library Trustee/Commissioner .......................  $30.00  Library Support Staff .......................................  $25.00  Author/Supporter/Retiree ..............................  $25.00  Library Science Student ...................................  $10.00  New Renewal Phone State Zip/Postal Code Country Middle Name Last Name Yes  Yes Share Email?  REFORMA will occasionally rent its member’s email and/or  mailing address to approved vendors and/or organizations. Membership Dues Total: TOTAL PAYMENT ENCLOSED: payable to REFORMA Scholarship Donation Total: payable to REFORMA Scholarship Fund Member‐at‐Large (No Chapter Affiliation)  INDIVIDUAL INSTITUTIONAL Corporation/Publisher ................................... $250.00 Library/Library School .....................................  $100.00  Non‐Profit Organization ..................................  $100.00  Bibliotecas para la Gente (San Francisco, CA) California Gold (Sacramento, CA)  Central Arizona  Colorado  El Corazón de Tejas (Austin, TX)  El Paso  La Estrella de Tejas (San Antonio, TX) Florida Libros (San Diego, CA)  Los Angeles  Midwest (IL, IN, WI)  New Mexico  Northeast (PA, NJ, NY, CT, RI, MA) Orange County (CA) Oregon Puerto Rico  Rio Trinidad (Dallas/Ft.Worth, TX)  Tucson Washington  No  No Please complete all sections of this application Member Information International Member .......................................  FREE Membership Annual Dues Academic Public Special School Other If you work in a library, please specify the type of Library: Share Mailing Address? Last updated: 5/14/2015 $ 0.00 $ 0.00