LWV of Black Hawk-Bremer Counties Membership Form
Information on this form will be used to complete your membership upon receipt of your check.
Send your check to Pat Harper, Membership Chair, at 3336 Santa Maria Drive Waterloo, IA 50702. Our local League website,
First, Middle, and Last Names
Street and house number, or Apartment Number, if needed
City, State, Zip Code
I would like to join as
You'll have to add these up to determine the amount of your check Make check out to "League of Women Voters Black Hawk-Bremer." April 2019: we have a limited Spring Special for the first 6 people who contact us for a half price membership fee.
Household: $30 for each additional household
College Student: $20
Limited Spring 2019 Special--HALF PRICE MEMBERSHIP for the first SIX people who sign up!
Primary Household Member
If someone in your household is joining as an additional "Household" member, who is the primary member? Please list the names of family members joining.
Do you have a Facebook account? If so, find us at
How did you hear about our League?
Attending a Legislative or Candidate Forum
Are you interested in getting involved?
Helping register people to vote
Helping at Candidate and Legislative Forums
Helping write Letters to the Editor
Helping staff a table for League at public events
(Use the Comments below)
Thank you for joining League! Check the Google Calendar on the website to get news about our activities. Any comments or suggestions for how we can more effectively reach out to the community?
Send me a copy of my responses.
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