EmersonAFEC.com

~ Affiliated Faculty of Emerson College ~

Membership Application (please print this page & mail) Name _____________________________________________________ Last First MI Home Address (we are required to use home addresses for AAUP election materials) ____________________________________________________________ Street / Apt # ____________________________________________________________ City State Zip E-mail __________________________________________________ Work Phone _______________________________________________ Home Phone _______________________________________________ Office Address _____________________________________________ ____________________________________________________________ Preferred mailing address: ____ office ____ home (we are required to use home addresses for AAUP election materials) Academic Field______________________________________________ ___ I enclose $70 for dues ($44 for mandatory national and state conference dues, and $26 for local chapter dues). Attached is check payable to the AAUP. ____________________________________________________________ (Signature) (Date) ___ Please do not include my name on any non-AAUP mailing lists. Print and mail to the Secretary of AFEC-AAUP: Diane Pansen, 169 Lakeshore Road #1, Brighton, MA 02135 or leave your application in a sealed envelope in Diane’s campus mailbox on the 11^th floor of Ansin building, 180 Tremont Street.

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