LWV of Black Hawk-Bremer Counties Membership Form
Information on this form will be used to complete your membership upon receipt of your check.
Email address *
Send your check to Pat Harper, Membership Chair, at 3336 Santa Maria Drive Waterloo, IA 50702. Our local League website, http://www.lwvbhb.org/
Name *
First, Middle, and Last Names
Your answer
Address 1 *
Street and house number, or Apartment Number, if needed
Your answer
Address 2 *
City, State, Zip Code
Your answer
Telephone *
nnn-nnn-nnnn
Your answer
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.
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.
Your answer
Do you have a Facebook account? If so, find us at https://www.facebook.com/BlackHawkBremerLeague/
Your answer
How did you hear about our League? *
Are you interested in getting involved? *
Required
Comments
Your answer
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?
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service