MLNC Membership Application Form

Institution Name:
Type of Library:	Four-year Academic Two-year Academic School Public Government/Non-Profit Corporate
User Base:	Enter the appropriate number for the Type of Library* chosen above:* Four-year Academic: FTE Two-year Academic: FTE School: Number of Students Public: Population Served Government/Non-Profit: Full-time employees with Access Corporate: Employees with Access
Membership Category:	MLNC Member
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:	Invoice my Library Pay by Credit Card (We will send an email invoice to the primary contact listed above with links and instructions for credit card payment)

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 MLNC Support.

MLNC
13610 Barrett Office Dr., Suite 206, Ballwin, MO 63021
800-969-MLNC (6562) • 314-394-1320 • Fax: 314-394-1326
Send comments to webmaster. Copyright 1999-2011 MLNC