Please print out this page and fill out this Membership Application Form and mail with your check to:
Name________________________________________________________
Name(s) of additional member(s) in household__________________________
Address______________________________________________________
City_______________________________ Zip Code __________________
Phone (home)___________________
Phone (work/day)_________________
Cell phone_______________Email address____________________________
Amount enclosed $______________________
($40.00 one member. $60.00 two members same household. Other available membership categories: $50.00 for a Supporting Membership, $75.00 for a Contributing Membership, $100.00 for a Sustaining Membership.)
Special Fund: Dorothy Hores Memorial fund/LWVAZ Education Fund - $____
(Membership categories above $60.00 are tax-deductible if the check is made out to LWVAZ Education Fund. Otherwise,.
Dues are not tax deductible.)
Comments (e.g. interests, how you heard about the League)
____________________________________________________________
____________________________________________________________
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League of Women Voters of Sedona-Verde Valley, Arizona. All rights reserved.