Membership Form

Please print this page, fill in the needed information and mail to

The Hemingway Society
Susan Beegel, Editor
14 Terhune Drive
Phippsburg, ME 04562
 

We welcome your check or money order in US dollars, or your payment by Visa or MasterCard.

NAME:

 

ACADEMIC AFFILIATION:

 

ADDRESS:

 

CITY, STATE, ZIP CODE:

 

COUNTRY:

 

PHONE:

 

E-MAIL:

 

FAX:

 

MASTERCARD OR VISA CREDIT CARD #:

 

EXPIRATION DATE:

 

AUTHORIZED AMOUNT (circle appropriate amount):

        $20 US students        $25 retirees        $30 regular members
 

SIGNATURE: