Robert Penn Warren Circle Membership Form

If you would like to become a member of the Robert Penn Warren Circle or renew your membership simply print this form, fill in this form, and mail along with your payment to the address shown at the bottom of the form.

Date of My Application_______________

Dues for membership in the Robert Penn Warren Circle are $15 a year, ($5 per year for graduate students), free for retirees—although emeritus contributions are always appreciated. Membership, which is valid from April to April, includes an annual newsletter and notices of upcoming conferences, calls for papers, panels, and publications.

I wish to become (check one) a new member___ or renew___ my membership in the Robert Penn Warren Circle. Enclosed please find payment for (check one)$15___ $5.00___ (graduate student rate)

Check here if you are a retiree______

Your Name:___________________________

Affiliation:_________________________

Mailing address: Street or P.O.Box_______________________________________

City________________________________ State_________ Zip____________

I grant permission for my name and mailing address as shown on this form to be included in future issues of the Circle Newsletter._____Yes_____No

Permission is also granted for my name and e-mail and mailing address information as shown on this form to be shown on the www.robertpennwarren.com web site(check here) Yes____ No____. If yes, enter e-mail address here______________.

 Mail this form along with check (unless you are a retiree) for membership dues to :

John Burt
Department of English MS023
206 Rabb Hall
Brandeis University
Waltham, MA 02254