CIRA

Membership Application / Bulletin Subscription
Form

To join CIRA, print this form, and mail it with your membership dues to the address below.
Members receive the Journal of Iranian Research and Analysis and other occasional publications.




Date ____________________________

Name ___________________________

Affiliation ________________________

Address _________________________

_________________________________

_________________________________

_________________________________

[ ] Check box if new address

Office phone ______________________

Home phone ______________________

Fax _____________________________

E-mail ___________________________

 
Please 
    [ ] register me as a new member
    [ ] renew my membership to CIRA
for the following category (please circle)
  1. Regular member:
      2. a. Supporting ................$100
      b. Contributing ...............$70
      c. Family .........................$45
      d. Individual ...................$30
  2. subscription to the Journal of 

    3. Iranian Research and Analysis .......$30

    (Nonmembers should add $5.00 for
    Canadian subscription and $15.00
    for overseas airmail subscriptions.)
     

    Send your check made to CIRA to the address below. 
    Only checks drawn on a U.S. bank will be accepted

    Address:

    Valentine Moghadam
    Director, Women Studies Program
    Illinois State University
    Campus Box 4260
    Normal, IL 61790-4260
     
     

Visit CIRA’s website
www.dac.neu.edu/cira




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