Join the League Form

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

League of Women Voters of Greater Lafayette
P.O. Box 2085
West Lafayette IN 47996

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 $______________________

($50.00 one member. $75.00 two members same household. Other available membership categories: Students: $25.00. Dues are not tax deductible. Please make out the check to: League of Women Voters of Greater Lafayette )

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

____________________________________________________________

____________________________________________________________

Additional contribution to the League of Women Voters of Greater Lafayette: $______________

Contribution to the Fern Weber Fund to assist members with dues: $_______________

Fern Weber Funds are available to assist with partial payment of dues. If you would like more information, please note that on this form, or contact the League at info@greaterlafayette.in.lwvnet.org

Make a tax deductible contribution to the Indiana Education Fund to support the League's non-partisian citizen information efforts. Write your check to Indiana Education Fund and mail to

League of Women Voters of Indiana
10 West Market Street, Suite 1720
Indianapolis, IN 46204

Comments, suggestions, questions? Contact our webmaster. Last revised: June 14, 2010 12:47 PDT.

© Copyright League of Women Voters of Greater Lafayette, Indiana. All rights reserved.