Dreiser Society: Application

[print and mail]


Name ________________________________________

Title  _________________________________________

Institution  _____________________________________

Address  ______________________________________

City __________________________ State ______________________ Zip __________

Phone  (____)__________________________________

Fax      (____)__________________________________

Email  ________________________________________

 

Please make checks ($20.00, North America ($10 for students); $30.00, elsewhere) payable to Dreiser Society.

Send check and application to:

Gary Totten
Secretary-Treasurer, Dreiser Society
English, NDSU Dept. #2320
PO Box 6050
Fargo, ND 58108-6050
dreisersecretary@yahoo.com