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Name: |
_____________________________________________________ |
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Mailing Address: |
_____________________________________________________ |
City/Zip: |
_____________________________________________________ |
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Home Phone: |
_____________________________________________________ |
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E-Mail: |
_____________________________________________________ |
School District: |
_____________________________________________________ |
Building: |
_____________________________________________________ |
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Work Phone : |
_____________________________________________________ |
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Membership Type: |
____ Regular Membership ($10.00) ____Student Membership ($5.00) |
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Other Memberships: |
Member WSRA # __________ Member IRA # __________ |
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Include a check payable to: Interlake Reading Council |
Please print, fill out form, and send this form with your check to:
JoAnn Gadicke
Wilson School
1625 Wilson Avenue
Sheboygan, WI 53081
jgadicke@sheboygan.k12.wi.us
