AMERICAN ASSOCIATION FOR HEALTH, PHYSICAL EDUCATION, AND RECREATION

A DEPARTMENT OF THE NATIONAL EDUCATION ASSOCIATION
1201 Sixteenth Street, Northwest, Washington 6, D. C.

APPLICATION FOR MEMBERSHIP

Enclosed find payment for. membership. Amount $___----_-_-_____
’ (Type of Membership—See Reverse Side of Blank)

 

Begin membership with month of Oct. _ Jan. April (check one): apeie * fis

|e Membership

Renewal of Membership_______________.___.

 

(Type or Print)

> a for
(Type or print clearly) Publications

Name : Address

 

 

 

Are you a member of the National Education Association?
Yes ; No "Ss hoentaceriemen. caviie Student membership must be endorsed by head of major department.
. ° * 3

Willard E. Givens, 1201 Sixteenth Street, N. W., Washing-
ton 6, D.C. Endorsement

 

 

 

 

 

(Head of Major Department)

 

(See other side)