Join the League Form

League of Women Voters^®
of Emporia

Please print out this page and fill out this Membership Application Form and mail with your check to:

League of Women Voters of Emporia
1702 West 13th Avenue
Emporia, KS 66801

Membership Application Form

Name________________________________________________________

Name(s) of additional member(s) in household__________________________

Address______________________________________________________

City_______________________________ Zip Code __________________

Phone (home)___________________ Phone (work/day)_________________

Cell phone_______________Email address____________________________

Amount enclosed $______________________
($45.00 one member. $67.50 two members same household. Other available membership categories: Contributing Individual $60.00 Contributing Household $75 Student/Supported $20.00. Dues are not tax deductible. Please make out the check to: League of Women Voters of Emporia )

Comments (e.g. interests, how you heard about the League)

____________________________________________________________

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Comments, suggestions, questions? Contact our webmaster. Last revised: November 17, 2009 14:42 PST.