American Association for Italian Studies Membership / Dues Form

Name
Position and Affiliation
Mailing Address
tel (office)
e-mail
Membership Categories:	*** Select one from the list *** $35.00 - Regular $25.00 - Student $50.00 - Couple $50.00 - Sustaining $100.00 - Patrons $450.00 - Lifetime
Optional Sections below:
Contribution to the Women Studies Caucus:	Regular: $10.00 Student: $5.00
Contribution to the Gay Caucus	Regular: $10.00 Student: $5.00