RSS MEMBERSHIP FORM

IMPORTANT: Thanks for printing clearly and providing all the requested information. If your institution

has multiple campuses, please note yours. You will receive an e-mail confirmation.

Name(s) (last, first): ___________________________________________________________

Institution: ______________________________________

Rank: ________________________

Complete Mailing Address: ______________________________________________________

____________________________________________________________________________

E-mail: ______________________________________________________________________

Phone (indicate whether home or office): ___________________________________________

Areas of concentration:
1) ________________________

2) ________________________

DUES SCHEDULE

Please circle the amount you are paying at this time.

Associate or full professor, administrator: 1-year $60

Assistant professor : 1-year $40
Adjunct, part-time, student, retired, or unemployed: 1-year $20

Mail this form, along with payment (a check or money order in U.S. funds), to Reception Study Society, c/o Philip Goldstein, 2 Andrews Way, Newark, DE 19711.