Membership Application
name _____________________________________________________
home address _____________________________________________________
city _______________________________ state ______________ zip ___________
phone _____________________________ email _____________
occupation _____________________________________________________
affiliation _____________________________________________________
work address _____________________________________________________
city _______________________________ state ______________ zip ___________
phone _____________________________ email _____________
send information to: work _____ home _____
_______ years of employment in field
education (field) _____________________ degree ___________________________
university ______________________________________________
Please indicate preferred membership status:
_______ Regular ($15) _______ Student ($10) _______ Subscribing ($10) _______ Affiliated ($10) _______ Institutional ($15) Please return application with dues to:
- Kelli Bacon
- NAPA Membership Chairperson
- c/o Archeology Division
- Nebraska State Historical Society
- P.O. Box 82554
- Lincoln, NE 68501-2554
- phone: 402-471-4766
e-mail: kelli.bacon