S W A L L T
Southwest Association for Language Learning and Technology

MEMBERSHIP FORM

Kindly share this form with your colleagues and friends. SWALLT welcomes administrators, faculty, and technical support professionals at all educational levels.

Please print out the completed form and mail to SWALLT treasurer.

Name
Position
Department
Institution
Address
City, State Zip
Phone
Fax
E-mail
Special Interest

Please check all applicable:
Would consider running for SWALLT office
Interested in hosting SWALLT meetings
Would be willing to serve on Committee
Newsletter editor

MEMBERSHIP YEAR:
MEMBERSHIP TYPE:
Please make checks payable to:   Shahnaz Ahmadeian for SWALLT      TOTAL ENCLOSED  $

Mail check and completed form to:

SWALLT TREASURER c/o
Shahnaz Ahmadeian - LTC Director of Special Programs
Language Acquisition Resource Center
San Diego State University
5500 Campanile Drive, SH-211D
San Diego, CA 92182

E-Mail: sahmadeianfard@mail.sdsu.edu
Phone Number: (619) 594-0846