Share: NAME(s) * - Please include all names and emails if Household Membership NAME(s) ADDRESS: * EMAIL (Preferred) * EMAIL (Alternative) PHONE (Preferred) * xxx-xxx-xxxx PHONE (Alternative) xxx-xxx-xxxx HAS ANY OF THE ABOVE INFORMATION CHANGED SINCE LAST YEAR ? * YES NO Please Check * Member Renewal New Member Transferring LWV membership to LWVCC Year Joined LWV * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025 Rejoining LWV * NO YES Are you a Life Member * NO YES MEMBERSHIP LEVELS * INDIVIDUAL $60 HOUSEHOLD $90 STUDENT $ 0 Basic membership dues are used exclusively to support the national league (LWVUS) and the state league (LWVMA). ADDITIONAL CONTRIBUTION ( $ ) Our local league depends on additional contributions from Members and Friends to support our local programs and initiatives. Please be as generous as you can. A contribution of any amount is greatly appreciated. Contributions are not tax deductible. AREAS OF INTEREST: i.e. Voter Services, Advocacy, Environment, Communications, Town Gov’t, etc.): Paypal PaymentClick here to submit form and pay with Paypal Leave this field blank CAPTCHAPlease confirm you are human to prevent spam submissions. Submit ------------------------------------------------------------------------------------------------------------------ The League of Women Voters and its members do not release membership lists. Share:
