Just print this page, fill it in and mail with your check or money order payable to:

League of Women Voters

PO Box 180

Lake Charles, LA 70602-0180

 

Date:

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Name:

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Address:

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City:                                                   State:                               Zip:

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Home Phone:                                             Office Phone:

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Cell Phone:                                                Fax:

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E-mail:

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_________ $55.00 Individual Membership

_________ $75.00 Household Membership (2 members at the same address)

_________ $30.00 Student Membership

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Issues I am most interested in: (check all that apply)

Education:            Health Care:              Environment:                 Crime:

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Other 

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I would like to participate in the following: (check all that apply)

Candidate Forums:                Board Position:                   Special Committee:

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Skills and/or time I can contribute:

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