Three Rivers TESOL

Institutional Membership Form

http://www.3rtesol.org

Membership year:  _______________________

 

Institutional membership fee: $150

Make checks payable to 'Three Rivers TESOL.

Mail application to:

Peter Kolenich English Language Institute University of Pittsburgh 2816 Cathedral of Learning Pittsburgh, PA 15260

Name of Institution:	______________________________________________
Contact Person:	______________________________________________
Address:	______________________________________________
	______________________________________________
	______________________________________________
Phone:	______________________________________________
E-mail:	______________________________________________
Names of people (up to two) included in this membership
1)	______________________________________________
Address:	______________________________________________
	______________________________________________
	______________________________________________
Phone:	______________________________________________
E-mail:	______________________________________________
2)	______________________________________________
Address:	______________________________________________
	______________________________________________
	______________________________________________
Phone:	______________________________________________
E-mail:	______________________________________________

Institution's URL to be linked to Three Rivers TESOL web site:

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