Complete this form if you would like to obtain a School or Organization Membership to LRCE. As a School or Organization Member, your LRCE benefits extend to your entire faculty and administrative staff. Only $200 a year for everyone to be a member! Join Now!

 

Call or email Janet at 1-800-449-1908 or (225) 924-7600 for details or questions.

	* Indicates required fields
*Name of School/Organization:
*Parish:
*Number of Faculty/Staff:
*Contact Name:
*Principal/Director:
*Phone:
Fax:
*Email:
*School Address:
*City St, Zip:	* *
Additional Comments:
*Please Select One:		Please invoice my school/organization in the amount of $200.00 at the above address.
		My school/organization will mail a check in the amount of $200.00 to LRCE.
		Please charge my credit card $200.00.
*Charge Amount:
*Credit Card #:
*Name as it Appears on Card:
*Expiration Month:	Please Select the Exp Month 01 02 03 04 05 06 07 08 09 10 11 12
*Expiration Year:	Please Select the Exp Year 2007 2008 2009 2010 2011 2012 2013 2014 2015
*Billing Address:
*Billing City St, Zip:	* *