MEMBERSHIP FORM
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PLEASE JOIN US

The League of Women Voters Needs Your Support

___ $60 one-year individual membership
___ $75 one-year household membership
___ $75 Carrie Chapman Catt membership
___ $100 Susan B. Anthony membership
___ $25 student one-year membership
        (Please send a copy of your school ID in order to get the discount membership rate.)
___ I would like to give a $60.00 gift membership to the League of Women Voters of the City of New York.
         I have included the name and address of the recipient.
___ *Contribution to support LWV activities


Name / Names____________________________________
Address_____________________________________
City ____________________ State _____ Zip _________
Telephone Day____________________ Evening_______________
Email____________________ Fax_______________

TOTAL AMOUNT ENCLOSED $______________

* Please make tax-deductible donations payable to: LWVNYC Education Fund

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Please make your check payable The League of Women Voters of the City of New York. Send with your completed form to:

League of Women Voters of the City of New York
150 Broadway, 14th Floor
New York, NY 10038

* Please make tax-deductible donations payable to: LWV NYC Education Fund

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