APPLICATION FOR MALAS MEMBERSHIP

NAME: __________________________________________________.

DEPARTMENT: _________________________________________________.

INSTITUTION: _________________________________________________.

ADDRESS: _____________________________________________________.

CITY: ___________________________. STATE: ______. ZIP: ______________.

OFFICE PHONE: ____________________________. FAX: ___________________________.

EMAIL: _______________________________________________.

OTHER INFORMATION: ___________________________________________.

Please send your annual dues check (US$10) to:
Dr. Phil Kelly
MALAS Secretary-Treasurer
Department of Political Science
Emporia State University
Emporia, KS 66801
USA

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This page last updated on 5/18/00.