WISCONSIN TITLE 1 ASSOCIATION INDIVIDUAL MEMBERSHIP FORM
Membership dues for the 2007-08 school year are $30.00. Membership covers only the person named on the form.
NAME _________________________________
POSITION_______________________________
SCHOOLDISTRICT______________________________________________________
ADDRESS______________________________________________________________
CITY/STATE/ZIP_________________________________
PHONE_________________
FAX ______________________________
EMAIL ______________________________
MEMBERSHIP #: _____________________ (You will only have a number if you were a member last year. Check with the treasurer if you do not know your number. Email: leeb@cashton.k12.wi.us
Make $30.00 check payable to: Wisconsin Title 1 Association Return payment and form to: WT1A Treasurer, 194 Katie Lane, Cashton, WI 54619
The Wisconsin Title I Association awards scholarships to several former Chapter 1 or Title 1 students each year to help them with post -secondary costs. We invite members and others interested in supporting the continued development of these young people to donate to the fund to keep this fine tradition going. Please accept my donation of _______________ for the WT1A Scholarship Fund. This donation is in ... ___ honor of : _______________________________ Please send a letter of acknowledgement to: (give name and address, please)
___ memory of: ______________________________ ___ recognition of: ____________________________ ___ Please acknowledge this donation at a meeting. ___ I would like the donation to remain anonymous
(Donor’s Signature) Thank you for donating to the WT1A Scholarship Fund
WISCONSIN TITLE 1 ASSOCIATION GROUP MEMBERSHIP FORM
Group membership dues for the 2007-08 school year are $100.00 for four members. Additional memberships from the district will be at same $25.00 each rate. Membership covers only the people named on the form. (Duplicate this page as need for memberships)
NAME ____________________________________ POSITION___________________________ SCHOOLDISTRICT______________________________________________________ ADDRESS ______________________________________________________________ CITY/STATE/ZIP_________________________________PHONE_________________ FAX ______________________________EMAIL_______________________________ MEMBERSHIP #: _____________________(You will only have a number if you were a member last year. Check with the treasurer if you do not know your number. Email:colburnm@cashton.k12.wi.us)
NAME ____________________________________ POSITION___________________________ SCHOOLDISTRICT______________________________________________________ ADDRESS ______________________________________________________________ CITY/STATE/ZIP_________________________________PHONE_________________ FAX ______________________________EMAIL_______________________________ MEMBERSHIP #: _____________________
NAME ____________________________________ POSITION___________________________ SCHOOLDISTRICT______________________________________________________ ADDRESS ______________________________________________________________ CITY/STATE/ZIP_________________________________PHONE_________________ FAX ______________________________EMAIL_______________________________ MEMBERSHIP #: _____________________
NAME ____________________________________ POSITION___________________________ SCHOOLDISTRICT______________________________________________________ ADDRESS ______________________________________________________________ CITY/STATE/ZIP_________________________________PHONE_________________ FAX ______________________________EMAIL_______________________________ MEMBERSHIP #: _____________________
Make $100.00 check payable to: Wisconsin Title 1 Association Return payment and form to: WT1A Treasurer, 194 Katie Lane, Cashton, WI 54619
The Wisconsin Title I Association awards scholarships to several former Chapter 1or Title 1 students each year to help them with post -secondary costs. We invite members and others interested in supporting the continued development of these young people to donate to the fund to keep this fine tradition going.
Please accept my donation of _______________ for the WT1A Scholarship Fund. This donation is in … ___honor of : _______________________________ Please send a letter of acknowledgement to: (give name and address, please)
___memory of: ______________________________ ___recognition of: ____________________________ ___ Please acknowledge this donation at a meeting. ___ I would like the donation to remain anonymous
(Donor’s Signature) Thank you for donating to the WT1A Scholarship Fund