INSTITUTION NAME: _____________________________________

 

CONTACT NAME: _______________________________________

 

ADDRESS: __________________________________ CITY: ___________________

PROVINCE: ________________

POSTAL CODE: __________ TELEPHONE: ___________________

EMAIL: _________________________________________________

FEE SCHEDULE:

 

REGULAR     $40.00/YEAR

                $100.00/THREE YEARS      NEW_____ RENEW _____

Please make cheque payable to MALT.

OPTIONAL:

 

What type of library do you represent?

 

[  ] Academic

[  ] School

[  ] Public

[  ] Special

 

What type of library professionals do you employ?

 

[  ] Librarians

[  ] Library Technicians

[  ] Library Assistants/Clerks

[  ] Other -__________________________________________

 

Any information you provide to us is for membership purposes only.

It will not be shared with or sold to any other organization.