Name________________________________Phone:(H)______________(W)_______________
Address_______________________________________________________________________
Zipcode___________________County_____________E-Mail___________________________
Second Household Member___________________________________________
| Full Membership (Open to county residents who are US citizens and age 18 or older) |
Annual Dues $60 | $________ |
| Second Household Member | Annual Dues $50 | $________ |
| Individual Sustaining Membership | Annual Dues $100 | $_______ |
| Household Sustaining Membership | Annual Dues $150 | $________ |
| Benefactor Membership | Annual Dues $250 | $________ |
All contributions to the League further promote our good work.
| A direct contribution to the LWV-Baltimore County Co. | $________ |
| A tax-deductible contribution to the LWV-Baltimore Co. Education Fund | $________ |
| A contribution to the LWV Baltimore County Lecture Series | $ |
| TOTAL REMITTED | $________ |
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