Membership

First Name on Credit Card*
Last Name on Credit Card*
Institution or Business Name*
Email Address*
Select a Membership Category*

Member's First Name*
Member's Last Name*
Job Title
Email Address

Optional if the same as the confirmation email address above.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Organization Website
Organization Catalog URL
Organization Phone
Add EBHL Membership + $20*
- Yes
- No
Secondary Address if Different from Above - NOT for the Directory
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website
Catalog URL
Work Phone
Home Phone Number
International Phone Number
Newsletter Format Option*
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.

Organization Website*
Organization Catalog URL
Organization Phone Number*
Is this Last Year's Designated Principal Member?
- Yes
- No
- Not sure
Please use same principal member's name as much as possible / Contact information for additional members may be added on page 2.
Principal Member's First Name*
Principal Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the Directory
Work Phone
Home Phone Number
International Phone Number
Hidden
Newsletter Format Option
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.
Add a Second Institutional Representative*
- Second Institutional Representative
- No
1-2 members included in the regular institutional membership fee ; $75 per additional institutional membership

Second Member's First Name*
Second Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the directory
Work Phone
Home Phone Number
International Phone Number
Newsletter Format Option*
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.
Add a Third Institutional Representative*
- Third Institutional Representative
- No
$75 additional to basic institutional membership

Third Member's First Name*
Third Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the Directory
Work Phone
Home Phone Number
International Phone Number
Notes
Clarifications, questions, concerns and/or compliments can be added here.
Add a Fourth Institutional Representative*
- Yes
- No

Fourth Member's First Name*
Fourth Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the directory
Work Phone
Home Phone Number
International Phone Number
Notes
Clarifications, questions, concerns and/or compliments can be added here.
Add a Fifth Institutional Representative*
- Yes
- No

Fifth Member's First Name*
Fifth Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the Directory
Work Phone
Home Phone Number
International Phone Number
Notes
Clarifications, questions, concerns and/or compliments can be added here.
Add a Sixth Institutional Representative*
- Yes
- No

Sixth Member's First Name*
Sixth Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the Directory
Work Phone
Home Phone Number
International Phone Number
Notes
Clarifications, questions, concerns and/or compliments can be added here.

Organization Website*
Organization Phone Number*
Is this Last Year's Designated Principal Member ?
- Yes
- No
- Not sure
Please use same principal member's name as much as possible / Contact information for additional members may be added on page 2.
Principal Member's First Name*
Principal Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Work Phone
International Phone Number
Newsletter Format Option*
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.
Add a Second Commercial Member Representative*
- Second commercial member representative
- No

Second Member's First Name*
Second Member's Last Name*
Job Title
Email Address*
Address - for Correspondence*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Work Phone
International Phone Number
Newsletter Format Option*
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.

First Name*
Last Name*
Title
Email Address

Optional if the same as the confirmation email address above.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add EBHL Membership + $20*
- Yes
- No
Work Phone
Home Phone
International Phone
Newsletter Format Option*
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.

First Name*
Last Name*
Name of Program
Email Address

Optional if the same as the confirmation email address above.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of School*
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the directory
Work Phone
Home Phone
International Phone Number
Newsletter Format Option*
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.
Add Scanned School ID
Max. file size: 50 MB.

First Name*
Last Name*
Email Address

Optional if the same as the confirmation email address above.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Organization Website
Organization Catalog URL
Organization Phone Number
Add EBHL Membership + $20*
- Yes
- No
Secondary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different from above - NOT for the Directory
Website
Catalog URL
Work Phone
Home Phone Number
International Phone Number
Newsletter Format Option*
- The Newsletter is now only available online at http://www.cbhl.net
Notes
Clarifications, questions, concerns and/or compliments can be added here.

Donation
- I would like to make a donation
Annual Literature Award (optional) $
Founders Fund Travel Award (optional) $
Charles Robert Long Award (optional) $
General Fund (optional) $
- I would like to pay the credit card fee associated with processing this gift! (Fee equals 2.9% of your contribution, plus 30 cents per transaction.)
Credit Card Processing Fee
Price: $0.00
Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

CBHL Interactive Directory

Step 1 of 14

Useful emails

Resources

CBHL Interactive Directory

Membership

Step 1 of 14

Useful e­mails

Resources

Useful emails