Personal Information Surname(s) : Given Name : Address Institution : Department : Street : City : Province : State : Postal Code : Country : Telephones (Include area codes) / E-mail Work Phone : Web site : Home Phone : E-mail : Membership Category and Annual Membership : Select One Category (All funds are in Canadian dollars) Regular Members Full-time Lecturer or Instructor: $ 75 Assistant Professor: $ 95 Associate Professor: $ 100 Professor: $ 115 Unemployed Regular Members or Part-Time Instructors: $ 50 Students: $ 50 Retired: $ 70 Three-year Membership $260 (Assistant Professor, Associate Professor, Professor) Associate Members Associate Member (neither Canadian nor resident in Canada). USA, Europe, Asia: $ 120 Associate Member (Resident in Latin America): $ 35 Affiliated Members Affiliated Members *Artists, Writers, Literary Translators - Canada, USA, Europe Residents: 40$ Affiliated Members + RCEH *Artists, Writers, Literary Translators who want to receive the RCEH (http://www.hispanistas.ca/revista/) - Canada, USA, Europe Residents : 70$ Affiliated Members *Artists, Writers, Literary Translators - Residents in Latin America - $20 Affiliated Members + RCEH *Artists, Writers, Literary Translators who want to receive the RCEH(http://www.hispanistas.ca/revista/) - Residents in Latin America: 50$ * If you belong to any of the previous member categories (Regular, Associated, Student, etc.) and you are also an Artist, a Writer, or a Literary Translator, do not select this category. Simply send the registration form (http://hispanistas.ca/Registro/) specifying it (first line of the form). Regions of Interest Primary research region of interest : Secondary research region of interest : Field(s) of Study (up to 5) Literature Colonial & Postcolonial Studies Linguistics Middle Ages / Golden Age / Baroque Language Pedagogy 18th and 19th Centuries Film Studies 20th and 21st Centuries Gender Studies Cervantes Cultural Studies Latin Canadian Writers Transatlantic Studies Chicano and Latino Literature in USA Narratology Avant Garde Poetry Art and Literature Theater Exile / Migration / Diaspora Payment Information Credit Card Type: Name on Credit Card: (please *do not leave* any *blank spaces*) Credit Card Number: Expiry Date: / (mm/yy) *ACH/CAH may contact your institution to confirm your enrolment.