Michigan Alliance of Reading Professors

MEMBERSHIP APPLICATION

Print out this form and send it with your $40 membership fee

($15 for students) to:

Lauren Freedman, Treasure

141 Selkirk Court
Kalamazoo, MI 49006

First and Last Name _____________________________________________________
Office Address _________________________________________________________

______________________________________________________________________________

Home Address__________________________________________________________

______________________________________________________________________

E-mail Address: ________________________________________________________
Phone (Home): ________________(Work): ______________ (Cell) ______________

Institution:_____ ________________________________________________________

Position: ______________________________________________________________

Major Work Responsibility _______________________________________________

Dues Amount Enclosed _____________________________

Would you care to donate to MARP? Donation Amount Enclosed_________________

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