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Name: |
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Mailing Address: |
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Home Phone: |
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Work Phone : |
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E-Mail address: |
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School District: |
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Position |
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MARC Membership $12.00 ($6.00 full-time College/ University Member) |
____ New Membership ____Renewal |
Other Memberships: |
Member WSRA # __________ Member IRA # __________ |
Membership runs for 1 year beginning August 15. |
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Include a check payable to: MARC |
Please print, fill out, and send this form to: Kristie Konsoer 102 Pine Ridge Trail Madison, WI 53717 |
