Mail-in Form for Directory Listing

If you are a member of the William Dean Howells Society and would like to have your name and other information listed in the Directory of Members, please print this form, fill it out, sign it, and mail it to the address at the bottom of the page. Because of privacy issues, we need written permission to list your name in the Online Directory.   Thank you.
 

Name: _______________________________________________________

Institution: _____________________________________________________

Address:______________________________________________________

_____________________________________________________________

City:________________________________  State: ____ Zip:______________

E-mail:________________________________________________

Web page:_____________________________________________
 

I give permission for my name and the following information to be listed in the online Directory of Members at the William Dean Howells Society site:

_____ All of the above information

OR (check all that apply)

_____ E-mail address

_____ Postal address

_____ Web page
 

Full name signature:

______________________________________________________
 

Mail to:

D. Campbell
Department of English
Washington State University
Pullman, WA 99164-5020

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Please send comments and suggestions to this address.