Advisory Council:

 

Advisory Council Application Form

You may join the Advisory Council either of two ways:

U. S. Mail -- If you prefer, click here for a printable form that you can fill out and mail to NECTFL.

Electronic Submission -- By filling out and submitting the form below, you will send us your application to join the Advisory Council. Please send your payment separately (see below).

2010 Northeast Conference Year

July 2009 - June 2010

Please provide the following information:

 
Organization/Institution:
Address:
Address:
City:
State:  Zip:

Membership Level and Fees:

Individual membership $100.00

Institutional membership $200.00

* PLEASE NOTE: Neither membership includes conference registration fee.

Representative or Contact: 
Mr. Ms.
Name:
Title/job/position:
Home Phone:
Work Phone:
FAX:
E-Mail:
Previous Contact Person or
Representative (if applicable)
 
Mr. Ms.
Previous Name:
 
Method of Payment:
Comments or
questions:
Click to submit your request. Click to clear your request and start over. After submitting your information, you will see a confirmation of your request which you may print if you need a copy of your submission.

Please mail payment (due by December 31, 2009) to:

NECTFL Advisory Council
Dickinson College
P.O. Box 1773
Carlisle PA 17013-2896

For credit card payments call us with your credit card number (VISA or Mastercard).

We can also invoice you through Paypal, which allows you to make online payments with these credit cards below (please contact us).

 

Phone us: 717-245-1977
FAX: 717-245-1976


Thank you for your prompt payment; it saves us time and money!


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