Membership Form
HQ76.3/New England

To become a member of HQ, print out the form below and mail it to the address indicated at the bottom:

NAME       _____________________________________________________________

MAILING         __________________________________________________________
ADDRESS
                   _______________________________________________________________

LIBRARY AFFILIATION (IF DIFFERENT FROM ABOVE ADDRESS)

_________________________________________________________________

PHONE__________________________________FAX_______________________

EMAIL__________________________________OTHER_____________________




VOLUNTEER INTEREST

I would like to volunteer or am interested in the following
activities/projects:

____Newsletter (including publicity and electronic formats)

____Political work (e.g. legislative awareness, censorship)

____Clearinghouse (collecting and making available information
       of interest to lesbigay library workers)

____Archives (assisting or setting up archives for lesbigay
         institutions or private collections)

____Lectures (e.g. arranging speaker series)

____Exhibitions (for HQ76.3/New England, or helping someone with an
         exhibition of interest to the group)

PLEASE RETURN FORM TO:

HQ76.3/NEW ENGLAND
JOHN DESANTIS
P.O. BOX 446
AMHERST, MA 01004

THANK YOU!

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