Membership — The MLTA

To join the MLTA, complete the form below

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Town library name

Town library address

Select your membership level

Individual membership ($25/year)

Senior individual membership ($20/year)

Individual lifetime member ($100)

Board membership ($100/year)

If board membership was selected, please include each board member's name, mailing address, and email address.

I intend to submit my payment:

Online

By check