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Memphis Area Library CouncilInstitutional MembersINVOICEInstitutional Membership Form July 2010 - June 2011
Complete the form below. Please make your check or money order payable to
 Memphis Area Library Council 
(FEIN: 621-35-2886).Mailing address
:
Melody Pittman, MALC TreasurerGermantown Community Library1925 Exeter Rd.Germantown, TN 38138PLEASE PRINT
1.Library Name:Chief Voting Representative:Title:Address of Library:City:State:Zip Code:Phone: Fax:*E-mail:Library’s Web Site:Second Voting Representative (if applicable):E-mail:Phone: Third Voting Representative (if applicable):E-mail:Phone:2.Type of Library: Public Academic Special School3.Dues for Institutional Membership - based on your Library’s operating budget.Checkthe appropriate category and enclose payment in the corresponding amount.
Operating Budget Dues Number representativesallowed
Up to $50,000 $35.001$ 50,000 -$250,000 $50.002$250,001-$400,000 $70.002$400,001-$750,000 $90.003$750,001 and above $110.003
*To receive confirmation of dues received by the Treasurer please provide emailaddress above.Visit our web site at
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