PACJE

We appoligize for not being able to have a downloadable file for you to fill out. Please Copy and Paste the Form below into a word processing program i.e microsoft word or word perfect, print out the form, fill it out and send it in.

Please make checks payable to PACJE.

Please send your 2010 annual dues/Membership fee of $35 and your $50 conference registration fee made out to PACJE, to our Secretary:

Annmarie Cordner (add in mailing address)

acordner@kutztown.edu

Kutztown University   

Department of Criminal Justice

(Please note that students need not pay the annual dues, and the student conference fee is $25.)

Annual dues ($35) __________

Conference fee ($50) __________

Student Conference fee ($25) __________

Total __________

IF PAID AFTER TBI

Annual dues ($35) ___________

Conference fee ($60) ___________

Student conference fee ($25) ___________

Total ___________

Name ______________________________________________________________

Position ______________________________________________________________

Affiliation ______________________________________________________________

Address ______________________________________________________________

______________________________________________________________

Phone: ______________ Email ___________________

Current Member: Yes_____ No_____

If no and would like to become a member please include annual dues along with conference registraion fees. Also please include a short statement indicating your intentions to become a new member.  

If unable to attend conference but would still like to become a member please complete registration form and submit dues and brief statement only.