For a printable version of this form, click here. 2009-2010 MEMBERSHIP IS NOW DUE (Fiscal Year July 1, 2009 through June 30, 2010) Please send your check for $10.00 for annual membership or $125.00 for life membership along with this form. Please print or type. Your cancelled check will serve as proof of payment. Do not include payment if you are already a life member, but do return this form. Please make checks payable to UARA. The return of your membership application and payment by October 15, 2009 will greatly assist UARA in planning for the coming year. (Please Print) Name:____________________________________________________________________ Address:__________________________________________________________________ (Street or Post Office Box) (Apartment Number) City:___________________________ST:______________________Zip:______________ Telephone:_______________________ST. Legislative District:_____________________ (If known) Email:____________________________________________________________________ Check one: _______$10.00 Annual MS ________$125.00 Lifetime MS ______I'm already a life member. Check one: _______Faculty _______Staff _______Appointed Personnel _______Spouse _______Other, please specify:__________________________________________________ Enclose Check Payable To: UARA PO Box 42391 Tucson, AZ 85733