Form

League of Women Voters^®
of Missouri

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

League of Women Voters of Missouri
8706 Manchester Road, Ste 104
St. Louis, Missouri 63144-2724

Membership Application Form

Name________________________________________________________

Address______________________________________________________

City_______________________________ Zip Code __________________

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

Cell phone_______________Email address____________________________

Amount enclosed $______________________
(55.00 one member. Other available membership categories: Members-at-large dues-$55,Columbia/Boone County dues-$50, Kansas City-Jackson/Clay & Platte County dues-$45,Mexico/Audrain County dues-$37, St. Louis dues-$60,Southeast Missouri dues-$40, Southwest Missouri dues-$50. Dues are not tax deductible. Please make out the check to: League of Women Voters of Missouri )

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

____________________________________________________________

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Comments, suggestions, questions? Contact our webmaster. Last revised: June 24, 2010 11:09 PDT.