THE CHILDREN'S LITERATURE COUNCIL OF SOUTHERN CALIFORNIA
2008 MEMBERSHIP APPLICATION

Membership is based on the calendar year, January through December. All dues are tax-deductible.
Checks should be made payable to:
The Children's Literature Council of Southern California.
To join, please print out this form, complete, and mail with your check to:

Membership Chair
The Children's Literature Council of Southern California
P.O. Box 573462
Tarzana, California 91357


NAME


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PHONE
e-mail

FAX
OCCUPATION

DESIGNATION (Check all that apply)
  Author
  Bookseller
  Illustrator
  Paraprofessional
  Public Librarian
  School Librarian
  Teacher
 

Other - Please specify:

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MEMBERSHIP STATUS: (Check one)
  New Member
  Renewal
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MEMBERSHIP TYPE: (Check one)
  Individual ($35.00)
  Institutional ($70.00)
  Supporting ($125.00)
  Student ($25.00)
  Retired ($25.00)

MEMBERSHIP DIRECTORY? (Check one)
  I do wish to be included in the Member Directory
  I do not wish to be included in the Member Directory