Indiana Association of Historians
Membership Application

Name____________________________________

Affiliation_____________________________

Address_________________________________

City____________________________________

State__________________ Zip____________

Email___________________________________

Area(s) of Interest

________________________________________

Basic Membership ($15)__________

Please make check payable to
"Indiana Association of Historians"
and mail to:

Dr. Joel D. Shrock
Department of History and Political Science
Anderson University
1100 East Fifth Street
Anderson, IN 46012