League of Women Voters of Atlanta-Fulton County
MEMBERSHIP APPLICATION
Print and complete this form and mail with your payment or Credit Card Information to:
League of Women Voters of Atlanta-Fulton County
PO Box 420705
Atlanta, GA 30342
New member
Renewal
Reinstate
Name ____________________________________________________________________
Address __________________________________________________________________
City ______________________________________ State _______ Zip ________________
Home Phone: ____________________ and/or Work Phone __________________________
E-mail ___________________________________________________________________
MEMBERSHIP DUES* Individual $60
Household $85
Full-time Student $30
Household Member Name ____________________________________________________
ADDITIONAL CONTRIBUTIONS
**Education Fund $______ Operating Fund $ ____ Other $ ______ (Specify __________ )
PAYMENT METHOD
Check to “LWV Atlanta-Fulton County” enclosed
Please Charge my: |
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AREAS OF INTEREST AND SERVICE
Voter service
Program
Public Relations
Fundraising
Membership
League Office
*Dues and most contributions are not deductible for tax purposes but may be deducible as ordinary and necessary business expense.
** Educational fund contributions are fully tax deductible. Appropriate contributions should be noted in the check memo section.