SEESA Membership Form

Please fill out this form and print it out completed. Send the form and a check to:

James Augerot
Department of Slavic Languages and Literatures
University of Washington
Box 353580
Seattle, WA 98185
Name:

Address:

Email:

Membership type:
(check one)		 One-year ($30; $15 students)

Two-year ($50; $25 students)

Benefactor, life-time ($500)