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The Oriental Institute

Membership Form

Name 1:____________________________________________
Name 2:____________________________________________
(Family Memberships may be in two names at the same address)

Address____________________________________________

City/State/Zip________________________________________

Daytime phone_______________________________________

UC Student ID#_____________________________________

My check for __________ is enclosed.

(Make check payable to the Oriental Institute)

Please bill my MC/Visa:____________________________

Account number_____________________________________

Expiration date____________________________________

Signature__________________________________________


Please return this form with payment to:

The Oriental Institute Membership Office,
1155 East 58th Street, Chicago, Illinois, 60637 USA
Fax: (773) 702-9853

Revised: April 25, 2011

Home > Membership > Become a Member