WISCONSIN AHEAD

 

MEMBERSHIP FORM

 

WIAHEAD is committed to the principles of equal access and opportunities for all qualified students with disabilities so they can become full participants in higher education and in society at large.  It is the mission of WIAHEAD to provide professional support and development to postsecondary disability service providers in Wisconsin and to other individuals and organizations who share this same commitment.

 

 

WIAHEAD offers 3 types of membership:  Institutional, Professional and Student.   Please select (check) the membership type below and send it  along with payment to:

                                                Elizabeth Watson, Treasurer

                                                UW-Whitewater

1004 Roseman Building

800 W. Main Street

Whitewater, WI  53190

 

 

____   Institutional Membership  circle one:  Level l or Level ll

 

Level l Membership--$50 annually for 1-2 members with one vote each

 

Level ll Membership--$100 annually for 3 or more members with 3 votes.  To add additional voting members-add $10 each

 

____   Professional Membership-- $50 annually with one vote

 

____   Student Membership--$10 with no voting privileges

 

Name(s)        

 

Institution

 

Address                                             City                                                                 zip

 

Email                                                                                      phone