To join or renew membership by PayPal, please use the PayPal Donation form.

To join or renew membership by mail, using a check or money order, complete this registration form and return it to the Treasurer. You may fill in the form online and send the form electronically by using the button on the form. Alternatively, you may print and complete the form (or a facsimile) and mail it with a check payable to to "Polanyi Society":

Charles Lowney, Treasurer
Polanyi Society
10 Jordan St.
Lexington, VA 24450


Dues

            • US $35 - regular members
            • US $25 - library subscriptions
            • US $15 - students

             

Name:

Email:

   

Street address:

Phone (day):

 

       Phone (evening):

 

City, State:

   

ZIP / Postal Code:

   

Country:

 


Dues:

 $

Donation:

 $

Total payable to the Polanyi Society:

 $

Additional instructions: