MEMBERSHIP APPLICATION
LOUISIANA COUNCIL OF TEACHERS OF ENGLISH

Name_____________________________________________________

Address _________________________________________________

City ______________________________Zip code_______________

Email address_____________________________________________

Home phone ( __________) _________________________________

School or Workplace:______________________________________

Address____________________________________________________

City ______________________________Zip code________________

Work phone ( _______) _____________________________________

Print this application and send it with a check for $25.00 to Connie Deville, 2104 Jasmine, Opelousas, LA 70570