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| Membership Application |
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Membership in DCLA runs from calendar year January-December. Dues for the current year are payable by April 15. ____Renewal ____New Membership Member Name:___________________________________________________ Home Address:____________________________________________________ City: ______________________________ State: _________ Zip:____________ Title/Position:_____________________________________________________ Library:___________________________________________________________ Address:__________________________________________________________ City: ______________________________ State: _________ Zip:____________ Work Phone:_____________________ Home Phone:_____________________ E-mail Address: ___________________________ Fax:____________________ Send DCLA mail to: ___Home ___Work Membership Category: ____ Personal Membership $15.00 ____ Institutional Membership $20.00 Please make check payable to: Dade County Library Association And mail it with this form to: Juan Zaragoza Membership Chair, DCLA 18114 S.W. 143 PL Miami, FL. 33172 305-593-1223 Ext. 187 305-593-8318 FAX jzaragoza@albizu.edu I am interested in participating on the following committees: ____ Membership ____ Program/Workshop ____ Newsletter ____ Bylaws ____ Scholarship ____ Information Provider/Publicity |
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