218 Edisto Ave.
Columbia, SC 29205
_______ NO CHANGES _______
CHANGES AS INDICATED
Membership Category (check):
[ ] Newcomer [ ]
Member's Name ___________________________________________________________________
University department with which you are
affiliated (if any) ___________________________________
Spouse's Name (if any) ______________________________________________________________
University department with which your spouse
is affiliated (if any) _______________________________
Mailing Address ____________________________________________________________________
Telephone ____________________________ (home)
Note: Members responding by Oct. 15 will
be included in the annual membership directory.