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The Medieval
Association of the Pacific
Membership Application 2005-2006
MAP 2005-2006 membership
application form ( Download
)
Last Name
_________________ First
Name___________________
Renewal?
Yes No
If so,
list only changes.
Thanks!
Address _________________________________________________
________________________________________________________
________________________________________________________
PH#(h)______________ (o)______________ (msg)_______________
E-mail___________________________________________________
Affiliation/Independent_______________________________________
Time Period_______________Discipline________________________
Geographical area__________________________________________
Specific Interests___________________________________________
________________________________________________________
____This information may be printed in Chronica and published
on the
MAP website.
____Please do not
print or publish this address, phone, or E-mail address.
Dues: $50 gift ;
$35 gift ; $25 gift ; $25 regular; $15 student: $______
(Canadian $37.50/ $22.50)
(Japanese members
may compute the appropriate fee and send their dues
in Yen to Prof. Yukio Arai)
Make checks
payable to the Medieval Association of the Pacific
Mail to:
Mary-Lyon Dolezal
Department of Art History
University of Oregon
Eugene, OR 97403-5229
Prof.
Yukio Arai
Graduate School of Humanity
Ochanomizu Women's University
2-1-1 Otsuka
Bunkyo-ku, Tokyo
JAPAN 112-0012
yarai@ma.kcom.ne.jp
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