Primary Member Information First Name * Primary Member Last Name * Title * Consortium/Organization * Email * Address 1 * Address 2 City * State * Zip * Legislative District Information To find your legislative district click HERE. MN House - None -1A1B2A2B3A3B4A4B5A5B6A6B7A7B8A8B9A9B10A10B11A11B12A12B13A13B14A14B15A15B16A16B17A17B18A18B19A19B20A20B21A21B22A22B23A23B24A24B25A25B26A26B27A27B28A28B29A29B30A30B31A31B32A32B33A33B34A34B35A35B36A36B37A37B38A38B39A39B40A40B41A41B42A42B43A43B44A44B45A45B46A46B47A47B48A48B49A49B50A50B51A51B52A52B53A53B54A54B55A55B56A56B57A57B58A58B59A59B60A60B61A61B62A62B63A63B64A64B65A65B66A66B67A67B MN Senate - None -01020304050607080910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667 Additional Member InformationIf you are signing up for an organizational membership please list member's names and email addresses. Please download this file and open in your preferred spreadsheet application. Fill out your member list, rename the file to refer to your organization, upload to the file uploader field below. Upload Member List Using the sample member list spreadsheet file (link above) please fill out your member list and upload the file here. Rename the file to identify your organization. XLS, XLSX, and CSV file formats are acceptable. Committee InformationPlease check the committee(s) that you would like to join (for committee information and details see the LAN website at www.literacyactionnetwork.org) Committee Options Legislation Summer Institute Professional Issues Volunteer Issues Membership and Marketing Finance None Membership Category Membership Options * $200 Organizational, includes 5 members ($40 each additional member) $50 Individual (renewing) $35 Individual (first time member) $25 Community Advocate or Volunteer $1 ABE or College Student Payment Method * Bill me Send a check Pay with a credit card or bank account (write down your total to input when prompted) Total membership dues are not calculated automatically. Please write down your membership dues amount for your reference when making a payment. Upon form submission you will receive payment directions. A confirmation email will be sent to the primary member please print the email for your records. Thank you for your support of the Literacy Action Network! Purchase order number (if applicable) CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
