Membership Form -- AAUP -UI Chapter
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Name: *
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Department: *
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Personal E-mail: *
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Rank: *
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Home address: *
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Monthly Dues: *
Please select the level of dues from the list below; monthly dues include national and chapter dues
Until further notice, I request monthly PAYROLL DEDUCTION for future dues payments. *
(If you prefer payment by check or credit card, please download, print and fill out the paper membership form linked to at the top of the page.)
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University ID *
Required to process payroll deduction request
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