Delaware Valley Medieval Association
2003-2004 Membership Form
Please provide information in the spaces below and return the form with your
dues
by 1 December to
Dorothy M. Shepard , Treasurer
118 Library Place
Princeton NJ 08540
CATEGORY OF MEMBERSHIP (circle one): Regular ($30) Student ($10)
Name
:
Mailing Address:
Telephone Number(s):
Home:
Office:
Fax:
E-mail Address:
Institutional Affiliation:
Discipline (short description; i.e., History, Romance Literature, etc.):
Subfields (brief description, i.e., Iconography, Social History):
Directories:
Please [ ] do list me in the printed Membership Directory
[ ] do not
Please [ ] do list me (name, institution, discipline, and e-mail only) in the online directory.
[ ] do not
Other academic groups (libraries, museums, etc.) or institutions (Princeton and Penn, esp.) sometimes approach us for our membership list. We are very selective, only providing our list with the understanding that it is to inform you about up-coming events.
Please [ ] do include me on a list shared with other academic groups in the area.
[ ] do not
Courtesy Privileges at the University of Pennsylvania Library?
[ ] yes
[ ] no