Northeastern Association of Two-Year Colleges, Inc.
             Individual Membership Form

Name _______________________________________________________________________ (Last) (First) (M.I.)
Institution _______________________________________________________________ Address ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Dept. ________________________________ Title ______________________________
Home Address _______________________________________________________________ _______________________________________________________________ _______________________________________________________________
Please send mail to (please check): _____ Institution _____ Home
Work Phone __________________________ Home Phone __________________________ Email _______________________________ Fax _________________________________
My membership is enclosed for (please check):
_____ $25 Annual _____ $45 Two Years _____ $100 Five Years _____ $10 Retired _____ $300 Life

The amount enclosed is $__________ Date _______________

Please make checks payable to NATYC, Inc. and return to:
  Wilbert Donnay, CPA, Treasurer  
  Accounting Department  
  Borough of Manhattan Community College  
  199 Chambers Street  
  New York, NY  10007  
If you would like to serve on any of the committees listed below, please circle the item(s) of
interest of contact Donald Resse, Vice President, at
Association Committees
Regional Committees
Annual Conference
Awards New York City Location
Resolutions Long Island Proposals/Papers*
Publications Mid-Hudson  
    * If you have a proposal for a paper to present at a future Annual Conference, please contact Gus Petrides at or (201) 666-4199.
Programs Capitol District
Membership and Dues Central
Constitution and By-Laws North Country
Nominations Genessee Valley
Budget and Planning Western
  South Central

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