SOCIEDAD WESLEYANA
MEMBERSHIP APPLICATION
_____New Member ____Membership Renewal ____New Contact Information
Annual Membership Dues:
_____$25 Student ____ $30 Individual ________ $100 Institutional Membership
Please include a check or money order made payable to the Sociedad Wesleyana and mail to:
Rev. Jeannie Treviņo Teddlie, Treasurer
c/o: Mexican American ProgramPerkins School of TheologySouthern Methodist University P.O. Box 750133Dallas, Texas 75275-0133USA
Title:____________
Name: ___________________________________________________________
Address: _________________________________________________________
City: _____________________________ State/Province: ___________________
Zip: _________________
Country: __________________________________________________________
Institutional Affiliation: ________________________________________________
Phone: ___________________________________________________________
E-Mail: ___________________________________________________________
Website / webpage__________________________________________________
Other Contact Information: ____________________________________________
______ Please include me in the SW Members mailing list.
I am interested in the following work area(s):
___ Renewal of the church local, national, global
___ Networking
___ Education and Teaching
___ Scholarship and Research
___ Grants and Fundraising
___ Writing, Publishing, and Translating
___ Distribution
Signature:________________________________________________________
Date: ______________________________