CREATE Membership
The Evaluation Center
B-401 Ellsworth Hall
Western Michigan University
Kalamazoo, MI 49008-5237 USA
Telephone: (269) 387-5895
Name (please print) Dr. Mr. Mrs. Ms.________________________________________________________
Position _____________________________________________________________________________
Institution/Agency___________________________________________________________________
Mailing Address _____________________________________________________________________
City _______________________ State/Prov. ______________
Country __________________ Zip/Postal Code _______________
Telephone_______________________ Fax _________________________
E-Mail ___________________________________
Dues:
___ Individual $60 (1 year)
___ Individual $150 (3 years)
___ Student* $45
___ Institutional** $175 (1 year)
___ Institutional** $450 (3 years)
___ Annual subscription to Studies in Educational Evaluation
(optional) $102 (4 issues)
Total Amount Enclosed $ _________________
Make check payable to CREATE. Check must be in U. S. dollars (USD). Membership for 2003-2004 is good through June 30, 2004, and includes Volume 17 of the Journal of Personnel Evaluation in Education.
* Enclose a copy of your student identification (ID) card, a copy of a current paid tuition bill, or a letter on college letterhead signed by an official of the college attesting to the fact that you are a currently enrolled student at that institution.
**For Institutional Membership
1. Name: Dr. Mr. Mrs. Ms. _____________________________________________________________ Position __________________________________________________________________________ Mailing Address ____________________________________________________________________ City ________________________ State/Prov. _______________ Zip/Postal Code ________________ Country _________________________________ Telephone ________________________________ Fax _____________________________________ E-Mail ___________________________________ |
2. Name: Dr. Mr. Mrs. Ms. _____________________________________________________________ Position __________________________________________________________________________ Mailing Address ____________________________________________________________________ City ________________________ State/Prov. _______________ Zip/Postal Code ________________ Country _________________________________ Telephone ________________________________ Fax _____________________________________ E-Mail ___________________________________ |
3. Name: Dr. Mr. Mrs. Ms. _____________________________________________________________ Position __________________________________________________________________________ Mailing Address ____________________________________________________________________ City ________________________ State/Prov. _______________ Zip/Postal Code ________________ Country _________________________________ Telephone ________________________________ Fax _____________________________________ E-Mail ___________________________________ |