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 ($60)
__________ Household membership ($90) Second Member: ____________________
__________ Contributing ($100)
__________ Student ($15) - full time students
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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
LWVLC membership committee
_____ participate on the
LWVLV fundraising committee
_____ assist with public
relations to publicize LWVLC events
_____ attend some meetings
(board, membership, citizen education events)
Source: lwv_lc web site 09/15/2012