First Name *

Last Name *

Are you a current member of the Hauenstein Center, CLA Fellow, or CLA Mentor? *
- Select Option Yes No I'm not sure

Please call the Hauenstein Center at (616) 331-2770 to verify your membership status

Email *

Phone *

Address 1 *

Address 2

City *

State *
- Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Afr/Can/EU/ME Armed Forces Americas Armed Forces Pacific Baker Island California Colorado Connecticut Delaware Federated State of Micronesia Florida Georgia Guam Hawaii Howland Island Idaho Illinois Indiana Iowa Johnston Atoll Kansas Kentucky Kingman Reef Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Midway Islands Minnesota Mississippi Missouri Montana Navassa Island Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Palmyra Atoll Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territory of Pacific Utah Vermont Virgin Islands Virginia Wake Island Washington Washington D.C. West Virginia Wisconsin Wyoming

Zip/Postal *

Will you be attending the event in person or virtually? *
- Select Option Attending in person Virtually

Will you be attending the members reception? *
- Select Option Yes No

Would you like more information from the Hauenstein Center?
Please add me to the Hauenstein Center Mailing List
Please send me information on Hauenstein Center membership

How did you hear about this event? *
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First Name *

Last Name *

City *

How did you hear about this event? *
Email
Facebook
Postcard/Member Invite
GVSU Poster/Banner
Lanthorn
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First Name *

Last Name *

City *

How did you hear about this event? *
Email
Facebook
Postcard/Member Invite
GVSU Poster/Banner
Lanthorn
Not listed Please specify a value for How did you hear about this event?

First Name *

Last Name *

City *

How did you hear about this event? *
Email
Facebook
Postcard/Member Invite
GVSU Poster/Banner
Lanthorn
Not listed Please specify a value for How did you hear about this event?