Membership Form

Midwest Victorian Studies Association
2007-2008
--Membership Form--
(Print this form, fill it out, enclose a check made out to MVSA, and mail as indicated below.)

Name _______________________________________________

Title/Position __________________________________________

Institution _____________________________________________

Office phone ___________________________________________

E-Mail address _________________________________________

Fax number ___________________________________________

Mailing address _________________________________________

_________________________________________

Victorian research interests:

______________________________________________________________________________

___________________________________________________________________________

Membership Category: New member ____ (Dues $25) Continuing member ____ ($25)
New grad student member ____ (Dues free--3 yrs) Continuing gs member ____ ($10 after 3 yrs)

Optional contribution to the Arnstein Fund: _____________

(Note that MVSA dues and Arnstein Fund contributions are tax deductible.)

Send this form--with check made out to MVSA--to:

Julie Melnyk, MVSA Treasurer, The Honors College, University of Missouri--Columbia,
211 Lowry Hall, Columbia, MO 65211