Membership at Large Form

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For new inductees who are US residents and elected by an institution without an active BPM chapter, please use this form.

First Name

Second Name

Last Name

Permanent Mailing Address

Email Address

Phone Number

Workplace

Position Title

Library School Attended

Year Graduated

Please type your name as you would like it to appear on your certificate

Date

YYYY

Please complete and submit this form, along with your check or money order in the amount of *$100.00 made payable to Beta Phi Mu to:

Beta Phi Mu Headquarters
PO Box 292992
Davie, FL 33329

For credit card Payment, please send an email request to headquarters@betaphimu.org (a small processing fee applies).

International Membership Fee is $115.00

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