INSTITUTE OF MUSLIM MINORITY AFFAIRS                  Membership 2007

 

Name:______________________________________________________________________

Mailing Address:______________________________________________________________

___________________________________________________________________________

Telephone:______________________________ Fax:________________________________

E-Mail Address:______________________________________________________________

Please enroll me as a member of The Institute of Muslim Minority Affairs, London, U.K. Membership benefits include subscription to Journal of Muslim Minority Affairs, subsidized rates for publications under IMMA Book Series and information on conferences and seminars sponsored by IMMA.

 1. MEMBERSHIP:

 

 

 

 

Check ( v ) appropriate box

Dues

 

 (A) Full Member

 

 

US $ 60.00

 

 (B) Student / Retiree

 

 

US $ 38.00

 

 

 MEMBERSHIP DUES PAYABLE:

US $ ___________(1)

 

 2. IMMA CONTRIBUTIONS: 

 

 

 

Fund for Advancement of Minority Studies/Research

US $ ______

 

 

Fund for Publication of IMMA Book Series

US $ ______

 

 

Soft Currency Fund

US $ ______

 

 

 TOTAL IMMA CONTRIBUTIONS:

US $ _________(2)

 

  3. GIFT MEMBERSHIPS: 

 

 

  I would like to send _____ number of gift membership/s at @ $ 60.00
  each to the following:

 

Name: _________________________

Name: ______________________________

 

Address: _______________________

Address: ____________________________

 

 TOTAL FOR GIFT MEMBERSHIP:

 

US $ _________(3)

 

  4. TOTAL DUE: 

ADD (1), (2) AND (3) FROM ABOVE: US $ _______________(4) 

______ Enclosed is cashier's check/international money order in the name of
Institute of Muslim Minority Affairs

______________
Please charge my:

 

 Access

 

 

 Visa

 

 

 Diners

 

 American Express

 

 Master Card

 

Card Account Number:_______________________________ Expiration date:_____________________

Signature: _______________________________________________(mandatory for card authorization)

 

 

 

Please complete and return the form along with the payment to:

The Institute of Muslim Minority Affairs

46 Goodge Street, London, W1T 4LU, U.K.

Tel. /Fax: (44-207) 636-6740
E-mail: editor@imma.org.uk
Website: www.imma.org.uk 

Institute of Muslim Minority Affairs is registered in the U. K. as Charity No. 288143


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