individual membership form - Eastern Sociological Society

2013 ESS MEMBERSHIP & REGISTRATION FORM
The form below should be printed and mailed to ESS directly at the following address:
Department of Sociology
c/o Emily H. Mahon
William Paterson University
300 Pompton Road
Wayne, NJ 07470
Dues for calendar year 2013
Please remember you are joining for the calendar year 2013 regardless of what month it is now.
___ $65 REGULAR MEMBER: For members with income above $20,000 who do not wish to pay at the
Sustaining Member rate.
___ $100 SUSTAINING MEMBER: This is a voluntary contribution for members who are able to give the society
this level.
___ $100 JOINT MEMBERS: Two members, one address, and one copy of Sociological Forum.
___ $55 EMERITUS MEMBER: Retired members.
___ $30 STUDENT * / LOW INCOME MEMBER: For members with income below $20,000.
*Undergraduates at institutions with ESS Departmental membership are automatically ESS Members
Pre-Registration for Annual Meeting 2013
Available until shortly before the meeting. Registration onsite will be $10 more for all categories other than
Undergraduate
___ $50 MEMBER REGISTRATION for Sustaining, Regular, Joint, and Emeritus members
___ $20 STUDENT REGISTRATION for Graduate Students
___ $10 UNDERGRADUATE STUDENT REGISTRATION (for all undergraduate students. Undergrads who are
presenters need not become members if their institutions hold departmental memberships.)
___ $60 NON-MEMBER REGISTRATION for non-ESS members. (Unless explicitly exempted, all presenters are
expected to be ESS members.)
___ $30 NON-MEMBER GRADUATE STUDENT REGISTRATION (for non-ESS members who are graduate
students. Unless explicitly exempted, all presenters are expected to be ESS members)
Awards and Lectureship Fund:
Your voluntary contribution will help the ESS awards fund grow. It supports the Robin M. Williams, Jr. Distinguished
Lectureship, the ESS Merit Award, the Komarovsky Book Award, plus the annual Candace Rogers and Rose Laub Coser
awards for graduate students.
Your Contribution: $____________
TOTAL AMOUNT FOR MEMBERSHIP, PREREGISTRATION and AWARDS/LECTURESHIP:
$___________
(see next page for payment details)

Contact Information
Your Name: _____________________________________________
ESS ID# (if known):
_________
Do you prefer to receive your mail at: work________ home _________
If you wish to receive ESS Newsletter by US Mail, Please check here: ______:
(Default Delivery of newsletter is electronic, which saves substantially on postage.)
Department: _______________________________________
Organization/School: ________________________________
Your Work Address
Street: _________________________
City: ___________________________
State: ________
Zip Code: ______________
Telephone: ___________________
Fax: ___________________
E-mail: ________________________________________
Your Home Address
Street: _________________________
City: __________________________
State: _______
Zip Code ______________
Tel: ________________________
Fax: ________________________
E-mail: ______________________
Payment Information:
Checks: Make payable to Eastern Sociological Society
Credit Card Type (circle): MasterCard Visa
Credit Card Number: _______ _______ _______ _______
Expiration Date:
Card owner:
Billing address:
_______ _____ (Month and Year)
______________________
______________________
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