Indiana Reading Journal Volume 44 Issue 1 | Page 5

5

Indiana State Reading Association

Membership Form

ISRA Membership for Period

July 1, 2015 through June 30, 2016

Please Print or Type

Name ______________________________________________________________________

School / Business ____________________________________________________________

Home Address ______________________________________________________________

City __________________________________ State __________Zip Code _____________

Home and/or Work/ Phone ____________________________________________________

Home and/or Work E-Mail ____________________________________________________

Make check payable to Indiana State Reading Association (ISRA) in the amount of $25.00.

A confirmation email will be sent to you after receiving your membership dues.

Send check and form to: Chris Riley

2315 Cedarwood Way

Fort Wayne, IN 46804

You may also join on-line at www.indianareads.org for $25.00.

Chris Riley

Membership

260-341-2612

[email protected]

Membership Form Received _________

Date