Membership Form / Dues Payment

Mail in Dues Payment or Use Paypal

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

League of Women Voters of Brookline
PO BOX 67056
Chestnut Hill, MA 02467-9998
617-566-3238

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: Student (under 25 years) -- $25; Dues are not tax deductible. Please make out the check to: League of Women Voters of Brookline (LWVB)

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

____________________________________________________________

____________________________________________________________

To pay online using a credit card or electronic funds transfer, click on the button below. ($50.00 one member. $75.00 two members same household. Other available membership categories: Student (under 25 years) -- $25). Please indicate in the notes box on the payment screen whether this is a renewal or a new membership. Thanks!

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Comments, suggestions, questions? Contact our webmaster. Last revised: August 15, 2011 17:20 PDT.

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