MAPS Membership Application Form

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MAPS MEMBERSHIP APPLICATION

Please print this on your printer so you can fill it out and mail it to us along with a check for the appropriate amount.
Please print or type clearly so we can read it.

As an alternative method of dues payment, PayPal applications are taken over our website at www.MAPS-ITG.org/JoinMAPS.

Name:		Date:
Street address 1:		Phone no.:
Street address 2:		Fax no.:
City:
State:		Postal code:
Country:
E-Mail:
Web page:

Would you like to be listed in our next printed membership directory?

O -- YES O -- NO

Would you like to be listed in the membership directory on the World Wide Web? If so, add a few lines about yourself for the listing.

O -- YES O -- NO

Mail completed form with your payment (made payable to MAPS) to:

John Hauger, MAPS Treasurer
3771 Chapel Rd
Spring Arbor, MI 49283-9732
U.S.A.

Include payment of the appropriate calendar year's dues:

$30.00 (U.S. dollars) for U.S. residents
$35 (U.S. dollars) for Canadian residents
$45 (U.S. dollars) for Euopean and Asian residents (China, Japan, Korea, Israel, New Zealand, Australia, South Africa, United Arab Emirates [UAE])

Applicant's Signature: _____________________

Date (month/day/year): ______ / _______ / 20_ _

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This page maintained by MAPS WebMaster and was last updated on November 13, 2010.