Application for Center for Oklahoma Studies membership

I am applying for the following status:

I am applying for the following status: Affiliate Associate
Name Name First Last
Position (rank, department, institution)
Oklahoma research interests
Work Address Work Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Work Phone Work Phone - ### - ### ####
Other Phone Other Phone - ### - ### ####
Email
Personal Web Site
Please indicate if you prefer for any of the above information to be excluded from your listing on the Center for Oklahoma Studies website.
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