Online MDMLG Membership Form

Please fill out the Online MDMLG Membership Form. Fields with an asterisk (*) are required.

Click here if you would prefer to use the PDF version of the Membership Form and mail your check.

Name *

Institution

Library/Department

Street Address *

City, State, Zip *

Phone (Voice)

Fax

Email

OCLC LIBID

Mailing Address (If different from above):
Do you want your mailing address to appear in the Directory:
Yes No
Street Address
City, State, Zip

Type of Membership:
Regular ($25)
Institutional ($40)
Student ($15)
Emeritus / Retiree ($15)

Please Check One:
Renewal
New Membership

Method of Payment:
Check (Make check payable to MDMLG)
Credit Card/Paypal

(We are using Paypal to accept credit card payments.
After you submit this form, you will be able to enter your credit card information.)