Louisiana Reading Association
Capital Area Reading Council
Membership Application
* Please print or type Date ______
Name______
First MI Last
Mailing Address ______
Street / P.O. Box
______
City State Zip Code
Home Phone ( ) Work Number ( )______
Email Address ______Fax ( )______
School District______Current Position ______
Work Place ______
LRA Member ___New ___Renewal
IRA Member ____Yes ____No If Yes, Membership Number ______
Indicate the local council you are joining.
___ Acadiana 21060 / ___ Nicholls 21420 / ___ St. Bernard 21660___ Calcasieu 21120 / ___ North Louisiana 21540 / ___ St. Charles 21680
_X_ Capital Area 21180 / ___ Northeast 21480 / ___ Southeast 21720
___ CENLA 21200 / ___ Northshore 21580 / ___ Washington 21800
___ DeSoto 21225 / ___ Northwestern 21600 / ___Title I Special Interest 21999
___ Jefferson 21300 / ___ Red River 21640 / ___ LA College Teachers
of Reading 21997
___ New Orleans 21360 / ___ Sabine 21655 / ___ West Feliciana 21275
Amount Due: Unified Dues (local and state) - $20.00
Student Unified Dues - $8.00
Amount Paid ______
Make check payable to Capital Area Reading Council (CARC). Mail to:
Capital Area Reading Council
c/o Sara Henderson
2040 S. Acadian Thwy.
Baton Rouge, LA 70808
For more information contact:
Cory Lemoine, President 1.225.772.4099
Louisiana Reading Association
Capital Area Reading Council
Membership Application
* Please print or type Date ______
Name______
First MI Last
Mailing Address ______
Street / P.O. Box
______
City State Zip Code
Home Phone ( ) Work Number ( )______
Email Address ______Fax ( )______
School District______Current Position ______
Work Place ______
LRA Member ___New ___Renewal
IRA Member ____Yes ____No If Yes, Membership Number ______
Indicate the local council you are joining.
___ Acadiana 21060 / ___ Nicholls 21420 / ___ St. Bernard 21660___ Calcasieu 21120 / ___ North Louisiana 21540 / ___ St. Charles 21680
_X_ Capital Area 21180 / ___ Northeast 21480 / ___ Southeast 21720
___ CENLA 21200 / ___ Northshore 21580 / ___ Washington 21800
___ DeSoto 21225 / ___ Northwestern 21600 / ___ Title I Special Interest 21999
___ Jefferson 21300 / ___ Red River 21640 / ___ LA College Teachers
of Reading 21997
___ New Orleans 21360 / ___ Sabine 21655 / ___ West Feliciana 21275
Amount Due: Unified Dues (local and state) - $20.00
Student Unified Dues - $8.00
Amount Paid ______
Make check payable to Capital Area Reading Council (CARC). Mail to:
Capital Area Reading Council
c/o Sara Henderson
2040 S. Acadian Thwy.
Baton Rouge, LA 70808
For more information contact:
Cory Lemoine, President 1.225.772.4099