Health Sciences OCLC Users Group
Membership Form 2002/2003

NAME
TITLE
LIBRARY
INSTITUTION
ADDRESS
PHONE
FAX
Internet/E-mail
Class of Membership		Individual: $10.00
		Active Institution: $25.00
Amount enclosed

Professional Affiliations
	ALA		MLA		Regional Medical Library Group or Chapter
	OLAC		SLA		Other
Type of Library
	Academic		Hospital		Pharmaceutical
	Government		Network		Other
Principle Job Activity
	Acquisitions		Cataloging		Coll. Development		Serials
	Circulation		Tech. Serv. Admin.		Automation		ILL
	Reference		One Person		Other
Library System
	DRA		Endeavor		Horizon		Innopac
	SIRSI		LIS		ExLibris		Cybertools
	Other

• Dues cover the fiscal year, July- June
  
• Dues include official newsletter, Start of Message
  
• Payment is for 2002/2003
  
• Make check payable to: HSOCLCUG

Please mail this completed form, with dues, to:

Wendy Fritzel, Administrative Secretary / HSOCLCUG
106 J. Otto Lottes Health Sciences Library
University of Missouri-Columbia
Columbia, MO 65212

E-mail: FritzelW@health.missouri.edu