Midwest Economics Association Membership Form


Please provide the following information to become a member of the Midwest Economics Association.

If you would like to mail or fax your membership, please click HERE for a printable form.

General Information

First Name:        Last Name:
Affiliation:
Business Street Address 1:
Business Street Address 2:
City: State (US ONLY):
Zip/Postal Code:
Country:
Telephone (Please include country and area code):
E-mail: (REQUIRED! Please be sure not to add a space before or after entering your email as this will cause an error.)

Billing Information (if paying online only - information must match credit card)

Information is the same as above

First Name (on Credit Card):   
Last Name (on Credit Card):
Street Address 1:
Street Address 2:
City: State (US ONLY):
Zip/Postal Code:
Country:
Telephone (Please include country and area code):


FEES:
Membership July 2008 - June 2009 ($10.00)


Additional Options:
Donation to the C. Woody Thompson Lecture Fund Amount: $
(enter only dollars and cents, i.e. 25.00)

           

Comments or Questions regarding this form? Mail them HERE.