RKRC |
Racine-Kenosha
|
Please print this form, complete, and mail it to the address below with your membership fee.
Name:____________________________________________________________
Street Address: _________________________________________________________
City/Zip: ________________________________________________________
Email: _______________________________________________________
School: ___________________________________________________________
District: ___________________________________________________________
Position: ___________________________________________________________
Work Phone: _______________________________________________________
IMPORTANT INFORMATION
Please check if you are a member:
Are you a member of WSRA? __________ WSRA Number ____________ Exp. Date ________
Are you a member of IRA? ____________ IRA Number _______________ Exp. Date ________
Are you a new member of IRA within the past 6 months?
YES __________ NO ___________
| Regular Membership: $10.00 | Student Membership $5.00 |
| Faculty member's signature (*Required for student membership.)
________________________________________________ |
Amount enclosed: ___________
Send this form and check made out to RKRC to:
RKRC Treasurer
Sarah McMillian
KTEC Charter School
714 49th St.
Kenosha, WI 53144
Please register with Ann Smith for all meetings via email: asmith@kusd.edu
