League Membership Form


LEVELS OF ANNUAL MEMBERSHIP DUES
60.00 Individual (1)
85.00 Household (2 individuals with same address)
25.00 Student
100.00 Susan B. Anthony Individual
125.00 Susan B. Anthony Household

*Required
*First and Last Name 1:
First and Last Name 2:
*Email 1:
Email 2:
Home Phone:
*Cell Phone1:
Cell Phone2:
*Street Address:
*City:
*State:
*Zip:

My Areas of Interest Please check all that apply
Voter Service Education Natural Resources
Speaker's Bureau Local Government Health Care
Fundraising and Finance Legislative Action Justice
Hospitality and Events Publicity and Public Relations Observer Corps
Women's Issues International Relations Social Media/Facebook
Telephone Committee Membership Recycling
The Voter Newsletter Website