Membership Form
NOTE: This is not an on-line form. Please print the page, fill it out, and mail it to the address at the bottom of the form.
The International Lawrence Durrell Society
Membership in the Society entitles you to receive The International
Lawrence Durrell Society Herald, the Society's membership directory,
and advance information about the biennial Lawrence Durrell conferences
and activities. Your membership dues help fund these conferences as well
as other Society activities and publications.
Name: ___________________________________________________________________________________
Home Address: ____________________________________________________________________________
_________________________________________________________________________________________
Home Telephone: __________________________________________________________________________
Office Address: ___________________________________________________________________________
_________________________________________________________________________________________
Office Phone: ___________________________________
FAX:_____________________________________
E-Mail: __________________________________________________________________________________
Where do you prefer to receive mail? _________________________________________________________
_____ Student single membership is $10.00 a year. _____ Regular single membership is $15.00 a year.
_____ Double membership (two people, one address) is $20.00 a year.
I wish to pay my membership dues for ____________________ year(s).
Contributions to the International Lawrence Durrell Society are tax deductable
under U.S. law [509 (a) (1)]. I wish to make a tax-deductable contribution
of________________ .
Subscriptions to Deus Loci: The Lawrence Durrell Journal:
($10/year additional; add $2/year surface mail or $8.00 for air for subscriptions to be sent outside of North America)
Enroll me for a continuing subscription to Deus Loci beginning
with issue number ____________.
Individual orders:
Send me ________ copies of Deus Loci numbers _________________________________.
Issues available: #1 (1992), #2 (1993), #3 (1994), #4 (1995-96),
#5 (1997), #6 (1998), #7 (1999-2000), #8 (2001-2002), #9 (2003-2005)
Amount Enclosed:______________
Mail this form and your check or money order in U.S. dollars payable to the International Lawrence Durrell Society to:
Paul H. Lorenz, Secretary/Treasurer, International Lawrence Durrell Society,
3201 S. Beech Street #40, Pine Bluff, AR 71603 USA