Individual Membership Form 2018-2019

Personal Information

Name

First Name

Last Name

Phone

(###)

###

####

Fax number

Mailing Address

Email Address

Please submit this form and either:

1. Pay through PayPal or

2. Send the MIEC individual membership check to:

Treasurer of Maryland International Education Consortium

Nellie Pharr-Maletta

CCBC Catonsville,

800 South Rolling Road,

Baltimore, MD 21228

Upon receiving these documents, you will be contacted by the MIEC member so we can provide you with additional information. Any questions about the MIEC membership should be addressed to Dr. Saleha Suleman, MIEC founder and inaugural president at ssuleman@towson.edu

Thank you for joining the MIEC as an individual member. We look forward to working with you in the upcoming years.