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Organization Name
Contact Name
Title
Address (where you receive mail from CLMP--can be different from address that appears in member directory)
Street

City
State or Province / Zip
/
Country(if other than US)

CLMP membership dues are based on your organization's annual budget, i.e. total cash and in-kind support for the most recent fiscal year.

Use the sliding scale below to determine the range in which your budget falls, then indicate the corresponding dues amount:

Annual budget     Dues
$1-$10,000 $75
$10,001-$30,000 $90
$30,001- $50,000 $125
$50,001-$100,000 $175
$100,001-$200,000 $225
$200,001-$350,000 $350
$350,001-$500,000 $450
$500,001-$750,000 $600
$750,001+ $750
Non-U.S. Publishers $100
 
A tax-deductible contribution, in addition to your dues payment, will strengthen CLMP's efforts to serve and support literary publishers in the U.S.
Contribution: $

Total:
Billing Information ( Check if same as above.)
Name on credit card:
Street:
City:
State or Province / Zip:  /
Country(if other than US):
Type of card:
Card number:
Expiration date: (mm/yyyy)
Email Address:




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