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LWVEA Membership Form
Thank you for joining the LWV of East Alabama! We are happy to have you on board!
Please fill out this form and pay your dues with a credit card via PayPal or by mail (details at the end of this form).
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Name
*
Your answer
Email Address
*
Your answer
Mailing Address
*
Your answer
Phone Number
Your answer
What topics are of interest to you? Check all that apply.
*
Voting Access and Process
Voter Rights Restoration
Social Issues including heathcare, prison reform, tax reform
Local & State Government
Environmental Issues
Other: Add comments at the end of the form
Required
Type of Membership
*
Individual/Primary $55
Household of Two $82.50
Student (high school or college) FREE!
Name and email address of second household member, if applicable.
Your answer
Payment Method (details to follow)
*
PayPal
Check/Cash
Not Applicable (Student)
Anything else we need to know?
Your answer
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