(Complete this form and deliver to Marian Ashton, Resource and Referral Office, Jordan Hall, 3rd Floor)

ECHO Membership Information 

Name (please print) ________________________________________  

Email Address ____________________________________________  

Primary Phone ____________________________________________  

Secondary Phone __________________________________________  

Address _________________________________________________  

City ____________________________ State ______ Zip _________ 

Major: ¨ Early Childhood  ¨ Special Education  ¨ Counseling

¨ Other (please indicate) ____________________________________  

Anticipated year of graduation: ________________________________  

What areas of interest would you like to see as a focus of our ECHO meetings (please check all that apply): 

¨ Creative activities 

¨ Curriculum development 

¨ Behavior management 

¨ Literacy advocate 

¨ Other (please indicate): ____________________________________  

Dues are $10 per year / $5 per semester. Please make your tax deductible check payable to ECHO. Mail / deliver to Marian Ashton, Jordan Hall, Room 325.

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