MLNC Membership Application Form




Institution Name:  
Type of Library: Academic
Public
School
Special (For Profit)
Special (Not for Profit)
Membership Category: Participant ($100.00 per year)
Associate Member ($150.00 per year)
Full Member ($550.00 per year)
Address:  
City:  
State:  
Zip:  
Telephone:
(Please include area code)		  
Fax Number:
(Please include area code)		  
Primary Contact:  
Title or Position of Primary Contact:   
Email of Primary Contact:  
Payment: Your institution will be invoiced for the membership fee at the address you have listed.

Credit Cards - Please do not apply online if you intend to pay with a credit card.  Instead, please use the fax membership application form and be sure to fill in the account number, expiration date, and cardholder's signature.

After clicking on Send Membership Application, you should be taken to a confirmation page listing the data that you entered in to this form.  If a confirmation does not appear on your screen, please contact Keri Cascio (x813) at the MLNC office.



Missouri Library Network Corporation
8045 Big Bend Blvd. Suite 202 St. Louis, MO 63119-2714
800-969-MLNC (6562) 314-918-7222 Fax: 314-918-7727
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