Brookyln College Faculty CiRcle

Membership Form

BROOKLYN COLLEGE FACULTY CIRCLE
Membership Form 2009-2010

 

NAME _____________________________________________________________

 

BC DEPARTMENT/OFFICE ________________________________________

 

ADDRESS __________________________________________________________

 

 ______________________________________ZIP__________________________

 

PHONE  #s  [HOME] _______________________  [OFFICE] x___________

 

E-MAIL ____________________________________________________________

 

Membership Dues: *

 RENEWING MEMBERSHIP  [ ]       NEW  FAC. / INST. STAFF (first year free)   [ ]
 ACTIVE    $30.00 [ ]                           RETIRED/ADJUNCT       $15.00 [ ]

 Additional Voluntary Contribution $_______

 TOTAL ENCLOSED: $____________

 

 

Brooklyn College Faculty Circle welcomes all full and part time faculty/instructional staff, HEOs, CLTs, Administrators and Retirees.

 

To be a member this year, please fill out this form and mail it with your check (Please make check payable to BC Member Organization, Memo: Faculty Circle) to:

 

 

Membership Chairperson

Brooklyn College Faculty Circle
Brooklyn College
2900 Bedford Avenue
Brooklyn, NY 11210-2889

 

*Entitles member to free admission to two events and reduced admission for fund raising events.