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Membership Form
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Epsilon Sigma Phi
Alpha Gamma Chapter-Alaska Active Members: National Dues@$30 plus State Dues @$6 = $36.00 Life Members (retirees): State Dues @ $6=$6.00 New Members: National Dues @$35 plus State Dues @$6 =$41.00 New Life Members (for new retirees): One time National Dues @$150 plus State Dues @$6 =$156.00 Membership Requirements: Alaska Chapter of Epsilon Sigma Phi membership is open to all Cooperative Extension employees (classified, APT, faculty). Make check payable to Alaska Chapter of Epsilon Sigma Phi Deadline: December 1st. If your address label is incorrect, please enclose it with this form and correct in the space below, or if you are a new member, complete the information below: Name:___________________________________________ Address:_________________________________________ City:____________________State:_______Zip:___________ Telephone:_______________FAX:_____________________ e-mail:__________________ Mail this form with your check to: Epsilon Sigma Phi-Alaska Chapter P.O. Box 81710Fairbanks, AK 99708 Any suggestions for improving the organization?____________ __________________________________________________ |
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