MEMBERSHIP FORM, Corpus Christi Chapter, International Thomas Merton Society

Name (please print) _____________________________________________

Street Address _____________________________________  Apt. ________

City ________________________  State _____________  ZIP ___________

Telephone (____) ______________  E-mail __________________________

___ 2014-2015 dues enclosed: $20.00 (students $10.00)
Additional contribution? ______________

Are you a member of the International Thomas Merton Society, Louisville, Ky? ____
(Membership in the ITMS is recommended to all Chapter members.  Click here for information on joining the ITMS.)

Make your check out to “Corpus Christi Church / ITMS Chapter
and mail it to:
Merton Society Chapter
Corpus Christi Church
529 West 121st Street
New York, NY  10027