The American Printing History Association
P.O. Box 4519
Grand Central Station
New York, NY 10163-4519          www.printinghistory.org   
Please print and complete this application.

2008 Membership Application

Name: _______________________________________________   [   ] Check here if renewing

Address: ____________________________________________      [   ] Check here if this is a gift

____________________________________________________

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Telephone: ____________________ E-mail: _____________________________________
Privacy: Your e-mail address and phone number, if provided, will not be disclosed to outside organizations. Telephone numbers will not be listed in the APHA Directory of Members.
[   ] Check here if you do not want to be listed in the APHA Directory of Members.
[   ] Check here to omit your e-mail address from the APHA Directory of Members. (Only your name and mailing address will be listed.)

Membership is on a calendar year basis. New members receive all journals and newsletters for the year in which they join (Jan. 1 through Dec. 31). Regional Chapters sponsor events and lectures in different parts of the United States. National Membership is a prerequisite to Chapter Membership.

	National Dues Enclosed (select one)	Subtotal
[   ]	Individual membership $45 / year	_____
[   ]	Institutional membership $55 / year	_____
[   ]	Contributing membership $90 / year *	_____
[   ]	Sustaining membership $200 / year *	_____
[   ]	Benefactor membership $500 / year *	_____
[   ]	Student membership $20 / year **	_____
	Subtotal of National Dues	_____

	Regional Chapter (select one)
[   ]	New York $15 / year	_____
[   ]	New England $10 / year	_____
[   ]	Chesapeake $10 / year	_____
[   ]	Southern California $15 / year	_____
[   ]	Northern California $15 / year	_____
	Subtotal of National & Regional Dues	_____
Optional contribution to support activities: APHA Endowment Fund		_____
	Total Enclosed	_____

* Contributing, Sustaining and Benefactor Members may choose one of the premiums listed here. Please list your choice of premium in order of preference:
(1) ___________________ (2) ________________ (3) _____________________
** Student Members should be currently enrolled in an educational institution and must have their student status certified in writing by an instructor or by a photocopy of a current, valid student identification card (with SSN blocked).

[   ] Check enclosed (payable to "APHA").
[   ] Charge my Visa / Mastercard (circle one)
Name on Card: _________________________________

Billing Address:  _________________________________

____________________________________________________

____________________________________________________

Card number: ___________________________________
Expiration date (mo/yr): ______/______     Security code: ______
Signature ______________________________________

Outside the United States, please add $5 to the above amounts. If not charging to a credit card, foreign members must remit in U.S. dollars through American banks, or by International Money Orders or Travelers' cheques in U.S. dollars. All publications to foreign members are sent air mail.

APHA is 501(c)(3) organization. Donations are tax deductible as charitable contributions to the extent provided by law. No goods, services or membership benefits were provided for your contribution. APHA has determined that membership dues are partially tax deductible as a charitable contribution, representing the excess over the value of goods or services, as follows: Benefactor ($485), Sustaining ($170), Individual ($30), Contributing ($60), Student ($5). Regional Chapter dues are fully deductible.

Privacy: concerned about the information you provide us? Read APHA's privacy policy for peace of mind.

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