*From which institution did you retire?


*What were your years of service there? to

Are you a president emerita/emeritus?
Yes No

In your retirement, are you doing any professional work?
Yes No

If yes, please describe:


What is your field of expertise?


Please write a one or two sentence description of the expertise and resources offered by you or your organization.

Are you interested in helping to recruit institutions for CIC membership?
Yes No

Please print this form and send it, a copy of your resume, and a check for $25 to:

Membership Manager, Council of Independent Colleges
One Dupont Circle, Suite 320
Washington, DC 20036
Tel: (202) 466-7230     Fax: (202) 466-7238
E-Mail: memberservices@cic.nche.edu