Membership Application

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(Print out form and mail to address below.)

Dues are $10.00 per year for both new and renewing members.
Membership lasts 12 months from date of dues receipt.

New Member ______                          Renewal _______

Name  __________________________________________________

Position _________________________________________________

Department  _____________________________________________

Institution  _______________________________________________

Address ________________________________________________

City ________________________   State ______  Zip ____________  

Phone __________________________________________________

FAX ____________________________________________________

Email __________________________________________________

Please make checks payable to NWALL (no purchase orders please).
Remit in U.S. funds only.

Mail form and check to:

University of Washington
Attn: NWALL
Language Learning Center
Box 353140
Seattle, WA 98195-3140
Phone: (206) 543-0536
Fax: (206) 685-7895
Email: llc@u.washington.edu

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