WISCONSIN TITLE 1 ASSOCIATION INDIVIDUAL MEMBERSHIP FORM
Membership dues for the 2008-09 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