S-T BPW Membership Form - New Members
Members are kindly asked to complete this form to apply for new membership or renew an existing membership no later than May 1, 2025.

Please contact us with any questions
soudertontelfordbpw51@gmail.com 
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Email *
First Name *
Last Name  *
Work Status: Home-School Mom / Company+Title / Retired / Other / Etc.
Street Address *
City *
ST *
Zip *
Preferred Phone *
Birthdate (Month and Day only is okay)
Dues are $32.00 for the year. Please note how you intend to remit payment. *
Required
Check Number
Interests
Personal Goal / Reason for Joining
Which committees would you like to PARTICIPATE IN?
If you're not sure, please leave it blank and you will be assigned a mentor who will be happy to explain the commitment involved in each selection and help you to choose. 
How did you hear about us?
Clear selection
Please specify the person who referred you or the community event referenced, or description for 'Other' from the question above.
A copy of your responses will be emailed to the address you provided.
Submit
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