VIRGINIA COLLEGIATE HONORS COUNCIL

Annual Dues Form

Calendar Year 2008

Mail to:

A. F. Conway

Secretary/Treasurer, VCHC

Honors Program, Randolph-Macon College

P. O. Box 5005

Ashland, VA 23005-5505

Call 804-752-3720 or email aconway@rmc.edu with questions. Checks should be made payable to VCHC.  (Federal Tax ID# 54-1345506)

Institutional               [   ]    $35.00

Individual (faculty)    [  ]    $10.00 each  

Name email

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Individual (students) [   ]    $10.00 each  

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Total enclosed:

College/University:

Address:

Honors Program Director/Contact Person:

Position:

Email: Tel: Fax:

This form is also available at http://www.longwood.edu/vchc/