BAAM Membership Only
(for those who wish to be a member of BAAM but cannot attend the conference)

Name __________________________________________________

Affiliation_______________________________________________

Address ________________________________________________

Address ________________________________________________

City____________________________________________________

State/Prov.________________ Zip/Postal______________________

e-mail__________________________________________________

Student membership    $ 5.00*
Full Membership         $10.00*

*The cost of advance membership will be deducted from your convention registration fee.

Print this form and send it to:

James T. Todd
BAAM
Department of Psychology
Eastern Michigan University
Ypsilanti, MI 48197