National Alliance of Women Veterans, Inc. Membership Form
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TimestampAre you a woman veteran or supporter?Are you interested in becoming a member of National Alliance of Women Veteran's Inc.What is your status of service?Are you commissioned or enlisted?What is your name?What is your State of ResidenceWhat is your age?Are you a member of any other women veteran organization?What is the organization's name?What are your preferencesWhat is the best way to contact you for further information?Please provide details.Are you a woman veteran, supporter or other?How do your prefer that we contact you?Membership ContributionsMembership OptionsPlease let us know what time is convenient to speak with you.What is your level of interest in volunteering with our organization? [not at all] [not at all]What is your level of interest in volunteering with our organization? [somewhat] [somewhat]What is your level of interest in volunteering with our organization? [interested] [interested]What is your level of interest in volunteering with our organization? [very interested] [very interested]What is your level of interest in volunteering with our organization? [excited about being involved] [excited about being involved]Please provide us your best contact information.TelephoneFaxEmail AddressEmail Address (Secondary)What is your preferred payment methodCredit Card Information can be received securely through our Paypal Account
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2/17/2012 0:16:07yesRetiredEnlistedCathy SantosPa55NoNaTier ThreePhoneWoman veteranGeneral MembershipEvening511112158344282821583442288667271221Cbsconsult@hotmail.comNaOther (Please state)www.nawvphilly.webs.com
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9/23/2016 13:39:13need more information RetiredEnlistedDoris EvertTennessee 71YesWomen veterans of America General MembershipPhoneWoman veteranGeneral MembershipAfternoon15333361 739 81483617398148No faxdorisevert@msn.com361 739 8148Fax or Phone Credit Card www.nawvphilly.webs.com
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5/2/2017 20:28:10yesActive DutyEnlistedSrstewart63CA54yesNABMWGeneral MembershipPhoneWoman veteranGeneral MembershipEvening12344minorprophet1@hotmail.com2138409786naminorprophet1@hotmail.comstephanie.stewart.js@gmail.comMail www.nawvphilly.webs.com
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2/21/2012 2:56:20need more information Active DutyEnlistedLahkeisha LeachPennsylvania31NoN/AGeneral MembershipEmailWoman veteranGeneral MembershipEvening11555Leach_L@Live.com856-577-8785N/aLeach_L@Live.comLeach_L@Yahoo.comFax or Phone Credit Card www.nawvphilly.webs.com
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3/19/2012 7:28:08yesRetiredEnlistedTheresa HastingsPennsylvania45NoNo OrganizationVolunteerEmailWoman veteranGeneral MembershipEvening11544Email215-435-3392no faxtmh33@drexel.edutmh33@drexel.eduFax or Phone Credit Card www.nawvphilly.webs.com
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3/21/2012 12:45:49yesOtherEnlistedMARCELLA STOKESPA41NONAGeneral MembershipPhoneWoman veteranGeneral MembershipMorning3333321544647272673318803215-873-8423 marcella.stokes@gmail.commarcella.stokes@gsa.govMail www.nawvphilly.webs.com
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5/28/2012 1:20:01need more information OtherReservistLaTrice HollinsPENNSYLVANIA26nonenoneVolunteerEmailOtherGeneral MembershipAfternoon45123267249959926724995990triceyhollins@gmail.comlfhollins@gmail.comOther (Please state)www.nawvphilly.webs.com
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7/6/2012 18:43:21yesRetiredEnlistedGlenda StatenNorth Carolina48NoPositivity 4 EverGeneral MembershipEmailWoman veteranGeneral MembershipMorning5511170445094107044509410704-878-2863glendasaten@msn.comglendastaten@aol.comMail Other (Please state)
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7/31/2012 13:23:27yesOtherReservistRobyn HowzellPennsylvania 45NoNoneVolunteerEmailSupporterGeneral MembershipMorning55555Robynhowzell@yahoo.com267-882-8339NoneRobynhowzell@yahoo.comRobynhowzell@yahoo.comOther (Please state)www.nawvphilly.webs.com
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11/2/2012 11:46:15need more information OtherReservistKimberly MumperPA45NOCrossroads Hospice of PhiladelphiaGeneral MembershipEmailSupporter, OtherGeneral MembershipAfternoon33333kimberly.mumper@crossroadshospice.com215-956-5110215-956-5175kimberly.mumper@crossroadshospice.comkimberly.mumper@crossroadshospice.comMail www.nawvphilly.webs.com
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11/15/2012 1:02:21yesOtherReservistNoritza PeritoNew York50noBe A Hero-Hire A HeroGeneral MembershipEmailSupporterGeneral MembershipMorning11333nperito@hireds.com845-624-3278845-215-0157nperito@hireds.comnperito@beahero-hireahero.comOther (Please state)www.nawvphilly.webs.com
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12/1/2012 16:36:10yesOtherEnlistedGolda Lawson-CohenPA49non/aGeneral MembershipEmailWoman veteranGeneral MembershipMorning33333glawsoncohen@gmail.com215.990.2218n/aglawsoncohen@gmail.comn/aPaypalwww.nawvphilly.webs.com
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12/10/2012 5:49:19need more information OtherEnlistedHelena BrunnelsonPennsylvania37NoN/AOther (Please state)EmailWoman veteranGeneral MembershipMorning11511yellowroselena@aol.com267-317-6437267-317-6437yellowroselena@aol.comyellowroselena@aol.comFax or Phone Credit Card www.nawvphilly.webs.com
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2/7/2013 16:48:21yesRetiredOfficerSuzan CostantiniPA59Noemployee of USDOL, Office of Federal Contract Compliance Programs. I will be doing a seminar this year on the protections female veterans have under our regulations. I am signing up for myself, not on behalf of OFCCP.VolunteerEmailWoman veteran, Supporter, OtherTier Two @ 40.00Afternoon11545email - any time during the day215-446-3769215-597-9447costantini.suzan@dol.govsuzan1014@msn.comMail www.nawvphilly.webs.com
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