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GATEWAY CAREER SERVICES ASSOCIATION OCTOBER 1, 2010 through SEPTEMBER 30, 2011 MEMBERSHIP RENEWAL/INVOICE INSTITUTIONAL ...

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GATEWAY CAREER SERVICES ASSOCIATION OCTOBER 1, 2010 through SEPTEMBER 30, 2011 MEMBERSHIP RENEWAL/INVOICE INSTITUTIONAL ANNUAL MEMBERSHIP - $100 “GCSA enables Illinois and Missouri career services professionals to serve their constituents better by providing professional development and networking opportunities.”

INSTITUTION: _________________________________________ DEPARTMENT NAME: ___________________________ ADDRESS: ______________________________________________CITY, STATE, ZIP: ____________________________ DEPARTMENT TELEPHONE: (

) ________________________________FAX: (

) __________________________

DEPARTMENT WEBSITE: ______________________________________________________________________________

MEMBER REPRESENTATIVES Please list ALL Career Services professional staff members, using a separate page if you need additional space. NAME DIRECTOR:

TITLE

E-MAIL ADDRESS

____________________________________________________________________________________________________

PROFESSIONAL STAFF: __________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________

Centralized or Decentralized?

Centralized __ Decentralized __

Accredited by the Higher Learning Commission of the North Central Association of Colleges and Schools? Yes __

No __

Last year of GCSA membership: _________________________________________________

Invoice Date:

INSTITUTION: (fill in institution name here)

Webster University Career Services Attn: Tamara Gegg-LaPlume (GCSA) 470 East Lockwood Ave. St. Louis, MO 63119 Phone: (314) 968-6982 Fax: (314) 968-7478 E-mail: [email protected] www.gcsa.siue.edu Federal ID#: 43-1590-145

MAKE CHECK PAYABLE TO GATEWAY CAREER SERVICES ASSOCIATION (USING ADDRESS AT UPPER RIGHT) AND SUBMIT BY SEPTEMBER 30, 2010.

ITEM

DESCRIPTION

UNIT PRICE

TOTAL DUE

Membership Dues

INSTITUTIONAL MEMBERSHIP (10/01/10-9/30/11)

100.00

100.00