LWV Membership Application

Becoming a member is easy.

Fill in this page and mail with your check or money order payable to:

League of Women Voters

PO Box 180

Lake Charles, LA 70602-0180

Date:

Name:

Address:

City:                                                   State:                               Zip:

Home Phone:                                             Office Phone:

Cell Phone:                                                Fax:

E-mail:

Please indicate membership choice.

_________ $55.00 Individual Membership

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

_________ $30.00 Student Membership

Oct. - March    $30.00/$13.75/$50.00

Full membership is open to every United States citizen of voting age.

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

Education:            Health Care:              Environment:                 Crime:

Other 

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

Candidate Forums:                Board Position:                   Special Committee:

Skills and/or time I can contribute:

League of Women Voters Lake Charles

PO Box 180  Lake Charles, LA 70601

337-474-1864

Website: www.lwv-lc.org   E-mail: info@lwv-lc.org