USA & International Membership Form – ASSOCIATION FOR CANADIAN JEWISH STUDIES

Individuals/Individuel
C$60.00 – US$70.00

Student, unwaged/ étudiant, non-salarié/e
C$25.00 – US$30.00

Seniors / Âge d’or
C$30.00 – US$35.00

Historical societies, libraries, archives, etc./ Société historique, bibliothèque, archives, etc.
C$65.00 – US$75.00

University or college programs or departments/ Programme ou département au niveau universitaire ou collégial
C$180.00 – US$190.00

Benefactor Member (donate/ renew simultaneously)/ Membre bienfaiteur (Faire un don/renouveler simultanément)
C$100.00 – US$110.00

Name/Nom*
First Last
Address/Addresse*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Tel: Home/résidence*
Tel: Business/affaires
Fax/télécopieur
Email/courriel*
Academic Affiliation/ Affiliation académique (please specify/ veuillez spécifier):
Member of affiliated society/ Membre d'une société affiliée (please specify/ veuillez spécifier):
Name
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