NEPCA
is funded by its annual membership dues and registration fees at the annual
meeting. Every effort has been made to
keep fees low. Please use this form to
register for the conference, to apply for membership, or to renew your membership
at any time. Contributions to the
NEPCA Fund are tax-deductible to the extent permitted by law. Make checks payable to NEPCA.
MAIL
TO: NEPCA c/o Robert E. Weir,
Name:
_____________________________________________________
New ___ Renewal ___
Mail Address:
__________________________________________________________________
_____________________________________________________________________________
_____________________________
ZIP CODE _________________
AFFILIATION:
_________________________________________________________________
SPECIALIZATION:
_____________________________________________________________
PHONE: _____________ EMAIL:____________________________
( ) ANNUAL MEMBERSHIP DUES
.. $30.00
( ) ANNUAL MEMBERSHIP DUES (for graduate
students, adjunct or emeritus faculty)
. $15.00
( ) LIFE OR INSTITUTIONAL MEMBERSHIP
$150.00
( ) NEPCA FUND CONTRIBUTION
$________
TOTAL CHECK (in U.S. FUNDS)
$__________
For additional information, Contact Robert E. Weir: