1. Please print and complete this application form.

Applicant Name	_________________________________________________
Address	_________________________________________________
City, State, Zip	_________________________________________________
Country (if non-U.S.)	_________________________________________________
Phone:	_____________________  Fax:_______________________
E-mail:	_________________________________________________
Institution Name	_________________________________________________
Institution Address	_________________________________________________
City, State, Zip	_________________________________________________
Country (if non-U.S.)	_________________________________________________
Website URL:	_________________________________________________
For Institutional Memberships, give the names of two institutional representatives:
Representative Name	_________________________________________________
Phone:	_____________________
Fax:	_____________________
E-mail:	_________________________________________________
Representative Name	_________________________________________________
Phone:	_____________________  Fax:_______________________
E-mail:	_________________________________________________

 

2. Select your type of Membership:

___ Institutional - $105 US/yr	___ Individual - $55 US/yr
___ Student - $35 US/yr	___ Retiree - $35 US/yr

 

3. Add fee, if necessary, for affiliate membership to EBHL:

___ Affiliate membership to EBHL - $20 US/yr

4. Please, mail the completed form

along with a check for annual dues (and affiliate membership, if necessary) payable to
The Council on Botanical and Horticultural Libraries, Inc., to:

Lisa DeCesare, CBHL Membership
22 Divinity Ave
Cambridge, MA 02138
Phone: 617-496-1025
EMAIL:ldecesar@oeb.harvard.edu

Other correspondence regarding CBHL may be sent to:

Charlotte Tancin, Secretary, CBHL
Hunt Institute for Botanical Documentation - Carnegie Mellon University - Pittsburgh, PA 15213-3890
Phone: 412-268-7301; Fax: 412-268-5677
EMAIL: ct0u@andrew.cmu.edu

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