[LWV] League of Women Voters®
of Piedmont

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 Piedmont
80 Florada Ave.
Piedmont, CA 94610


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 $______________________

($60. one member. $90. two members same household. Other available membership categories: Seniors - $55.. Dues are not tax deductible. Please make out the check to: League of Women Voters of Piedmont )

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

____________________________________________________________

____________________________________________________________


Contact us for more information.

Comments, suggestions, questions? Contact our webmaster. Last revised: July 23, 2010 10:28 PDT.

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