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Wisconsin Chapter of Catholic Library Association

MEMBERSHIP FORM

(Membership runs from September 1 through August 31.)

New _____ Renewal _____ Preferred mailing address: _____Home _____Work

Name ______________________________________________________________

School or Library _____________________________________________________

Address __________________________________ e-mail: ___________________

City _________________________________ Zip _______________

Home Address _____________________________ e-mail: ___________________

City _________________________________ Zip _______________

Home Phone ________________________ Work Phone _____________________

SECTION: (check one)

Elementary/middle ___ High School ___ Academic ___ Parish ___ Other ___

DUES: $15 librarians, teachers, institutional membership

$8 para-professional librarians, aides, volunteers, retired & supporting members

Please return this form, with payment, to Jean Elvekrog, 401 Doral Court, Waunakee, WI  53597