IRA Storytellers

Special Interest Group

Membership Form

_____ I would like to join the IRA Storytelling SIG.

_____ I am a current member of the International Reading Association
(must be an IRA member to be in a SIG)

                          IRA Membership # ________________________________

Name:  _______________________________________________________

Address: ______________________________________________________

City: _________________________________________________________

State/Province:  ________________________________________________

Zip Code: _____________________________________________________

School District/University: _______________________________________

Home Phone: (_______) _________________________________________
                       area code

Work Phone:  (_______) _________________________________________
                       area code

Email Address:  ________________________________________________
 

Amount Due:  $5.00 (US)

Make check to IRA SIG
Mail to: 

Mike Roe (Treasurer)
2985 Taylors Chapel Road
Crossville, TN  38572

Need information?  Check our website:  http://www.pampetty.com/sig.htm

or email SIG Chairperson:  Kathy Brashears kbrashears@tntech.edu

                                                   THANK YOU!