Wisconsin Association of Lactation Consultants

WALC Membership Form – March 08 through February 09

WALC Membership is open to all persons interested in promoting breastfeeding and supporting breastfeeding mothers. Members receive minutes of regular meetings, free CERPS at WALC meetings, discount for WALC conferences and a yearly Membership Directory. Yearly dues are $20. Memberships received by March 1st will be included in the annual membership directory.

Name ____________________________________________________________________________

Address __________________________________________________________________________

___________________________________________________________________________

Home Phone __________________________ Work Phone _________________________________

E-mail _________________________________ ILCA member yes / no (circle)

Are you an IBCLC yes / no (circle) Credentials for Directory _________________________

Employer _____________________________ Positions (Title) ______________________________

Anything else you would like mentioned in Directory (Brief) ________________________________

__________________________________________________________________________________

Would you prefer to get your minutes by mail ________ e-mail _________ website ________

***WALC is committed to providing members with the valuable information that is shared at our WALC meetings, September, November, January and May. Postage costs for these minutes are a large part of our budget. If you do not need a paper copy of minutes and are able to use minutes by email or website, that will help cut our costs. If you prefer mail, we are happy to send you minutes.

Any topics you would like to see covered at a WALC meeting? _______________________________

__________________________________________________________________________________

Any speakers we should know about? ____________________________________________________

Dues: cash _____ check _____ complimentary (reason) ____________________________________

Complimentary memberships are given to WALC officers and WALC member presenters.

WALC needs your input. Please indicate any areas of interest:

WALC Conference _________ WALC Officer ________ Other ____________________________

Make checks payable to: WALC Send to WALC Membership

c/o Sandy Testin

218 E Lake St

Waupaca, WI 54981