Leading the Way for Voters! Membership Form

Name:____________________________________________________

Mailing Address:____________________________________________

____________________________________________________________

____________________________________________________________

Day Phone Number:_________________Evening Phone Number:_______________

E-mail address:__________________________________________

Best day for evening meetings:__________morning meetings:____________

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Type of Membership (must be a US citizen, at least 18 years old)

            __________  Individual membership ($50)

            __________  Family membership ($75)

            __________  Student ($15)

Activities in which you would consider participating:

_____   assist in planning and implementing a citizen education program
_____   assist in planning and implementing a candidate forum
_____   participate in a voter registration drive
_____   review and type candidate survey data for Voter Guides
_____   participate on the membership committee
_____   participate on the fundraising committee
_____   assist with public relations to publicize events
_____   attend some meetings (board, membership, citizen education events)

Source: lwvmc web site 03/26/2007