Wisconsin Latin Teachers Association
Membership Form

Name:
__________________________________________________________
Address:
__________________________________________________________
Email:
__________________________________________________________
Phone Number:
__________________________________________________________
School, College, or University:
__________________________________________________________

Please mail this form and a $25 ($10 for students) check payable to WLTA to:

Bill Kean, Treasurer
110 S. Henry St., Apt. 204
Madison, WI 53703

Lifetime membership is $500.