Membership Application


Please enroll me as a member of the Michigan Entomological Society, in the classification checked below.

___ Active Member -- annual dues $25.00
___ Student Member (K-12 only) -- annual dues $12.00
___ Institutional Member (organizations, libraries, etc.) -- annual dues $45.00
___ Sustaining Member -- annual dues $35.00
___ Life Member -- $500.00


I enclose $ _______ (cash, check, or money order) as dues for the calendar year (s) _______, appropriate for the class of membership checked above. (Please make remittance payable to the Michigan Entomological Society).

Name _____________________________________

Address____________________________________

____________________________________________

City __________________________ State ________ Zip ____________

The following information is optional:

 

e-mail address ______________________________

Specific areas of interest (orders, families, behavior, etc.)

___________________________________________________

___________________________________________________


MAIL TO:

Michigan Entomological Society
c/o Department of Entomology
Michigan State University
East Lansing, MI 48824-1115

updated 04/05/2007