Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
LWV-VA Membership Application
LWVVA and some local Leagues currently offer free memberships to students who are currently enrolled in an accredited institution. If you live in an area with a local League that currently offers free membership you will receive follow-up guidance.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First Name:
*
Your answer
Last Name:
*
Your answer
Street Address -- Apt./Unit #:
*
Your answer
City:
*
Your answer
State:
*
Your answer
Postal Code:
*
Your answer
Phone:
*
Your answer
Birthday (Month/Day/Year)
Your answer
Are you interested in ...
Internship Opportunities
Serving on LWV-VA Board's Committees
Participating on Statewide Issue Groups or Positions Studies
Assisting with Social Media/Public Communications
Other:
How would you like to submit your dues?
*
Credit Card or PayPal
Check ( Please print out this application and send check to LWV-VA Treasure, Attn: Membership, 7827 Newington Woods Dr , Springfield, VA 22153))
Student Membership
Other:
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
