Committee Self Nomination Form | Wisconsin State Reading Association

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If you are interested in nominating yourself for a position on one of the WSRA committees listed below, please complete and submit this form. By clicking on the "Submit" button at the end of the form, your information will be directly emailed to:

WSRA Committee Liaison
1221 Seitz Drive
Waukesha, WI 53186

1. I am interested in serving on the following committees(s) in order of preference:

1st choice:
2nd choice:
3rd choice:

2. I am willing to serve as:

3. I belong to the following reading council:

4. Previously, I have served on these WSRA committees:

Name
E-mail
Home Address
City
State
Zip
Home Phone
Work Phone
Place of Employment
Position

This page last updated November 16 2006