Solicitud para la renovación o ingreso a Reforma Capítulo de Puerto Rico
1. Membership Application
Join online: www.reforma.org/join
Mail completed application and payment to:
REFORMA
P.O. Box 832
Anaheim, CA 92815‐0832
Chapter Affiliation
Payment
Dr. Mr. Mrs. Ms.
First Name
Street
City
Email
LIFETIME Membership .................................. $450.00
Librarian Earning >$60k/year ......................... $50.00
Librarian Earning $30‐59k/year ...................... $40.00
Librarian Earning <$30k/year ......................... $35.00
Library Trustee/Commissioner ....................... $30.00
Library Support Staff ....................................... $25.00
Author/Supporter/Retiree .............................. $25.00
Library Science Student ................................... $10.00
New Renewal
Phone
State Zip/Postal Code Country
Middle Name Last Name
Yes
Yes
Share Email?
REFORMA will occasionally rent its member’s email and/or
mailing address to approved vendors and/or organizations.
Membership Dues Total:
TOTAL PAYMENT ENCLOSED:
payable to REFORMA
Scholarship Donation Total:
payable to REFORMA Scholarship Fund
Member‐at‐Large (No Chapter Affiliation) INDIVIDUAL
INSTITUTIONAL
Corporation/Publisher ................................... $250.00
Library/Library School ..................................... $100.00
Non‐Profit Organization .................................. $100.00
Bibliotecas para la Gente (San Francisco, CA)
California Gold (Sacramento, CA)
Central Arizona
Colorado
El Corazón de Tejas (Austin, TX)
El Paso
La Estrella de Tejas (San Antonio, TX)
Florida
Libros (San Diego, CA)
Los Angeles
Midwest (IL, IN, WI)
New Mexico
Northeast (PA, NJ, NY, CT, RI, MA)
Orange County (CA)
Oregon
Puerto Rico
Rio Trinidad (Dallas/Ft.Worth, TX)
Tucson
Washington
No
No
Please complete all sections of this application
Member Information
International Member ....................................... FREE
Membership Annual Dues
Academic
Public
Special
School
Other
If you work in a library, please
specify the type of Library:
Share Mailing Address?
Last updated: 5/14/2015
$ 0.00
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