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Home / Membership / ACL Membership Application
ACL Membership Application
Please print out this form and mail or fax it to the below contact information:
Type of Membership (please circle one):
Small Consortium Regular Consortium Sustaining Membership
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Consortium/Organization Name:
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Contact Name:
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Address Line 1:
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Address Line 2:
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City/State/Zip Code:
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Phone Number:
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Fax Number:
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E-mail:
Please Mail or Fax this form to:
Dr. Lawrence Dotolo, Executive Director
c/o Virginia Tidewater Consortium for Higher Education
4900 Powhatan Avenue
Norfolk, VA 23529-0293
Phone: 757-683-3183
Fax: 757-683-4515
E-mail: lgdotolo@aol.com
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