koha-US 2018 Individual Membership
Group, institutional, and consortial-level memberships are not available at this time. Multiple individual memberships from any library/organization are welcomed.

Memberships are non-refundable, non-transferable, and will not automatically renew.

Information and a PayPal link to pay the annual membership fee will be presented after this form is submitted.

Email address *
First name *
Your answer
Last name *
Your answer
Library/Organization
Your answer
Address *
Your answer
Office/Suite/Apartment number
Your answer
City *
Your answer
State/Province *
Your answer
ZIP/Postal Code *
Your answer
Phone *
Your answer
IRC Handle (If you have one)
Your answer
About my library/organization (check all that apply) *
Required
Consortium
Are you part of a consortium? If so, please let us know the name of the consortium.
Your answer
Mentoring *
A mentor will be a person at another koha Library, or involved with the koha community that can answer questions about koha and common workflow practices. A mentor will not provide technical support, but may opt to help with reports or other tweaks in koha.
Membership *
Membership with koha-US is not official until membership dues are paid. Membership privileges are outlined in the koha-US ByLaws at http://koha-us.org/about-koha-us/administration/bylaws/, under Article II
Required
Payment method *
A link for payments via PayPal and instructions for check submission are on the confirmation page. Please do not send cash through the mail
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Koha-US.