Member-At-Large Membership Form
MAL Annual Dues (State & National) are $50.00 for one member, plus $75.00 for household. Students (full or part-time) may join for free at this time (this may revert back to $25 in the future). After completing this form you will go to PayPal to make your payment. Please specify your membership type in PayPal to be sure amount of dues is correct.

Dues are not tax deductible

Email address *
Are you a new or renewing member? ($50 individual, $75 household) *
Are you currently a student? *
Name of school attending (A student is defined as an individual who is enrolled either full or part-time in an accredited institution.) *
Your answer
Do you wish to receive information such as Action Alerts and Newsletters from LWV via email? *
Your First Name *
Your answer
Your Last Name *
Your answer
If you plan to join as Household, please provide other Household members name here.
Your answer
Your Birthdate (for statistical purposes only)
MM
/
DD
/
YYYY
Mailing Address (include city and zip code) *
Your answer
Primary Phone *
Your answer
Secondary Phone (if available)
Your answer
Due Payment Method *
A copy of your responses will be emailed to the address you provided.
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