| Enter your information or the information of the main contact person for institutional members. |
*Enter preferred email
(this will be your userID): |
|
| *Re-enter Email: |
|
| Title: |
|
| *First Name: |
|
| Middle Inital: |
|
| *Last Name: |
|
| Your Job Position: |
|
| Institutional Affiliation or Employer: |
|
| Enter your full mailing address below (duplicate institution if necessary). |
| *Address Line 1: |
|
| Address Line 2: |
|
| Address Line 3: |
|
| City: |
|
| U.S. State: |
|
| Zip or Postal Code: |
|
| Country: |
|
| We frequently get requests for one-time usage of our mailing list
(usually from publishers of peace-related literature). If you DO NOT want your name included on such a list,
check this box: |
|
| *Telephone: |
|
| Fax: |
|
| Personal or Institution's Website, enter URL after http:// |
|
| Where or from whom did you hear about PJSA? |
|
|
|
Select your membership level below,
a subscription to Peace & Change
is included, unless otherwise noted: |
| * |
|
| *Would you like to authorize an annual payment (to be charged to your credit card
on file annually at the rate selected above), or do you want to authorize a
one-time payment ONLY? |
|
| Special Promo Code: |
|
| If you DO NOT want your email included on our member-only list-serv,
check this box: |
|
| Today's Date: |
|
|
|
| After clicking Submit, please allow 10 seconds for the page to fully load. |
|
* denotes required field |
