St. Croix ValleyReading Council

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St. Croix Valley Reading Council Membership

 
  
Name:
 _____________________________________________________
Mailing Address:
 _____________________________________________________
City/Zip:
 _____________________________________________________
Home Phone:
 _____________________________________________________
School:
 _____________________________________________________
Address:
 _____________________________________________________
City/Zip:
 _____________________________________________________
School Phone:
 _____________________________________________________
Position:
 _____________________________________________________
Membership Dues:

____ Regular ($10.00)

____Student (FREE)
Other Memberships:

Member WSRA # __________ 

Member IRA # __________  

   

Include a check payable to: St. Croix Valley Reading Council
 

Please print, fill out, and send this form with dues to:

Jana Bast
655 Hillary Farm Road
Hudson, WI 54016