Membership Form

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Wisconsin Chapter of Catholic Library Association

New _____ Renewal _____
Preferred mailing address: _____Home _____Work

Name __________________________________________

School or Library __________________________________

Work 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

Membership runs from September 1 through August 31.

Please contact Debra Gilkes for assistance at debra.gilkes@aquinasschools.org

Please return this form, with payment, to:
Debra Gilkes
Blessed Sacrament School
4109 Cliffside Dr.,
La Crosse, WI 54601