Florida Reading Association
Membership Application
 

FRA Membership
Post Office Box 12187
Tallahassee, FL 32317-2187
www.FLReads.org

Circle  Appropriate :        New  Member                 Renewal

 Name________________________________________________________________________________

County__________________________________ E-mail_______________________________________

 Home Address_________________________________________________________________________

City______________________________ State/Country_________________________________________

Zip Code + 4_____________________________ Home Phone__________________________________ 

 Occupation:         ___ Elementary Teacher (PreK-5)       ___ Secondary Teacher (6-12
                                ___ District/School Administrator     ___ College/University Instructor
                                ___ Retired Educator                              ___ Student
                                ___ Consultant/Representative            ___ Other: __________________________________

I am a current member of:     ___ International Reading Association
                                                     ___ Local Reading Council: _________________________________________

The membership year is from July 1 through June 30.  Membership applications received after March 1 will become effective immediately and extend through June 30 of the following year.

 Membership Type:           ___  Regular $25

                                               ___  Retired $10

                                               ___  Full Time Student $10

                                                ___________________________                 __________________________
                                                Faculty Sponsor’s Signature  (Required)                                      College/University

 Make checks payable to:         FRA

 ___ VISA                 ___ MasterCard                       Expiration Date: ___ / ___ (month / year)

Card # _ _ _ _  -  _ _ _ _ - _ _ _ _ - _ _ _ _  Signature__________________________________________