Associate Membership Registration Form

Organization/Individual name

Street

City/Town

ZIP/Postal Code

Email

Phone

Payment: please select one

For-profit, 1-year $2,500

For-profit 6 months $1500

Individual, 1-year $2,500

Individual, 6-months $1,500

Non-profit, 1-year $1,000

Non-profit, 6-months $500

(Please note that non-profits must provide a copy of their ST-2 and/or renewal letter as proof of status.)

How would you like to pay?

Check

Credit card

Renewal Info

I would like a new library card

Yes

Important note to all library users:

As a user of the Tufts University Hirsh Health Sciences Library, you accept responsibility for the return of all materials borrowed from the library and from other libraries through document delivery. All fees incurred for lost, damaged or late items must be paid and failure to pay such fees may result in a loss of library privileges. You also agree to abide by all HHSL policies, and you are responsible for copyright compliance as well as Tufts University policies concerning the responsible use of resources. Please see information regarding the Library Associate Membership Program