Fillable ACCUTE 2020-2021 MEMBERSHIP FORM

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ACCUTE 2020-2021 MEMBERSHIP FORM

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Country of origin: CANADA
File type: PDF

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ACCUTE 2020-2021 MEMBERSHIP FORM
❑ Renewing Member ❑ New Member
A. MEMBER INFORMATION
Member Name:
Position/Job Title:
Institution/Organization:
Type of affiliation:
❑ College ❑ University
Delivery Address for ESC:
Postal Code:
Phone: Work: ( ) Home: ( )
Email:
B. SEE REVERSE TO ADD SECOND MEMBER IN HOUSEHOLD (IF N/A SKIP TO C. MEMBERSHIP CATEGORIES)
C. ME
MBERSHIP CATEGORIES
Ma
ny academics fall into multiple categories; please self-identify with the category that best represents your position.
# of
Members
Membership Category
Individual
Fee
Total
Graduate Student
$45
Contract Academic Faculty (incl. part-time, sessional, LTA)
$45
Post-Doctoral Fellow
$65
Retired Professor
$105
Instructor
$125
Assistant Professor
$125
Associate Professor
$150
Professor
$175
Other (please specify)
$45
SUBTOTAL (add figures in right-hand column)
SUBSTRACT $35 for the second member of a Household Membership
- $35
ADD Donation: Help fund a membership for an underwaged colleague (Optional)
ADD Donation: Help fund the Graduate Student Essay Prize (Optional)
TOTAL DUE
$
PAYMENT OPTIONS:
__ Cheque: Payable to ACCUTE, sent to:
ACCU
TE (Association of Canadian College and University Teachers of English)
c/o Department of English
University of New Brunswick
PO Box 4400, Fredericton, NB E3B 5A3
__ Credit Card: Type: ________________Number: ___________________________ CVV #: ____ Expiry: Month ____ Year ____
(Credit card information will be shredded immediately upon processing.)
B. HOUSEHOLD MEMBERSHIPS (two memberships, less one copy of ESC)
Second Member:
Job Title:
Institution/Organization:
Phone:
Work: ( )
Home: ( )
Email:
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ACCUTE 2020-2021 MEMBERSHIP FORM

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Completed 6 April 2021

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