Text Box: Membership Form 

Membership in the Catharine Maria Sedgwick Society includes a subscription to the newsletter and e-mail updates of all Society activities, including calls for papers.  The membership year runs from July 1 to June 30.  Membership expiration date appears on the newsletter address label to remind members of when it is time to renew.

Please be careful to write LEGIBLY!!
Membership (check one):
Regular	$10.	____	Institutional	$25.	____	Lifetime	$200.	____
International  	15.	____	Student  	5.	____			

Name 	________________________________________________________________

Affiliation 	________________________________________________________________

Preferred mailing address (Please use home, if possible; saves us space and time!):

_____________________________________________________________________________

Preferred e-mail address (only one, please): __________________________________________ 

Phone numbers  (H) _________________________   (O)  ____________________________

Would you like to receive e-mail updates from the Society?      _____ Yes  _____ No

Please return this form and your membership payment (by check or money order made payable to Sedgwick Society) to:  Deborah Gussman, 619 Wayne Avenue, Haddonfield, NJ 08033