Printer Friendly Form

SOHA logo

To become a member, please print out the following application, fill in the relevant information (as you would like it to appear in the directory), and mail it to the address below. Membership questions can be sent to kathleen.lehmer@fox.com.

Name__________________________________________________

Address_________________________________________________

City_____________________________State______ Zip_____________                    

Home Phone  (___)___-________

Work Phone   (___)___-________

Fax  (___)___-________________

E-Mail Address____________________@________________________

Institutional Affiliation_____________________________________

Membership Level (check one):
     __ Individual $25
     __ Student $15
     __ Institution $50/100/150
     __ Sponsor (individual) $50/100/150
     __ Friendship $15

     __ Lifetime $195

Please MAKE ALL CHECKS PAYABLE to SOHA

Send PAYMENT to :
Kathleen Lehmer (kathleen.lehmer@fox.com)
10315 Viretta Lane
Los Angeles, CA 90077

Please circle committees in which you might be interested:

    Newsletter   Membership    Annual Meeting     Grants/Scholarships

Thank you for your interest in SOHA!