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Minnesota Independent Scholars' Forum
Name____________________________________________________________
Address___________________________________________________________
City___________________________State_________Zip___________________
Phone: Home________________Work________________Fax_______________
E-mail address______________________________________________________
Check the amount of your remittance below:
__ $25 per year Regular
__ $35 per year Household (only one copy of mailings)
__ $75 per year Sustaining
__ $100 per year Donor*
__ $150 per year Benefactor*
*May be paid in monthly or quarterly installments.
Scholarships are available for those who need them. Please indicate on the application form if you need financial aid
and how much you would like. Thank you
We welcome your comments on the Forum, activities you have been or will be involved in, or anything else you would like
to share. (You can attach more sheets if you need more space to write.)
___________________________________________________________________
___________________________________________________________________
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Please use the space below to tell us about the people you know who might be interested in joining the Forum.
Name______________________________________________________________ Address____________________________________________________________
City________________________________State_________Zip________________
Phone numbers: Home___________________ Work________________________
Name______________________________________________________________ Address____________________________________________________________
City________________________________State_________Zip________________
Phone numbers: Home___________________ Work________________________
The Minnesota Independent Scholars' Forum keeps on record curriculum vitae or resumes of those members who wish to submit
them. Occasionally we are asked if we have members who are qualified in particular areas. If you would like to have your
vitae on file with MISF for this purpose, you can submit it with this form. Please note that completing the Interests Inventory
will help us identify your expertise more quickly. (If you complete the Interests Inventory but do not want the Matching
Interests Report, please indicate this on the Interests Inventory form.)
Please mail this form with your check to:
Minnesota Independent Scholars' Forum
P.O. Box 80235
Minneapolis, MN 55408-8235
MISF has a 501 (c) (3) status. All contributions are tax deductible to the full extent permitted by law.
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