Name: ______________________________________________________
Title: ______________________________________________________
Department: ______________________________________________________
University: ______________________________________________________
Street: ______________________________________________________
City: ______________________________________________________
State: ______________________________________________________
Country: ______________________________________________________
Zip Code: ______________________________________________________
Telephone: ______________________________________________________
Email Address: ______________________________________________________
Include in public directory of members? ___ Yes ___No
Dues: Regular: $25 per year; $75 for 3 years
Student: $10 per year
Lifetime: $250
To join or renew your membership, please send a check made out to "Kenneth Burke Society" and mail it to:
David Measel, Treasurer
103 Brandywine Ln
Anderson SC 29625