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Name: |
_____________________________________________________ |
Mailing Address: |
_____________________________________________________ |
City/Zip: |
_____________________________________________________ |
Phone Home: |
_____________________________________________________ |
Phone Work: |
_____________________________________________________ |
District |
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Specific Position |
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E-Mail (to receive newsletters): |
_____________________________________________________ |
Membership Type: |
____ New ($12.00) ____Renewal ($12.00) ____Full Time Student ($6.00) College/University __________________ |
Other Memberships: |
Member WSRA # __________ Member IRA # __________ |
Print, complete the membership form, and mail it with a check payable to MERC to: |
Laura Stondall For membership questions, contact Laurie Figlmiller at 920.734.7554 or figlmillerlaur@aasd.k12.wi.us . |