LWV of Carroll County
c/o Carol Blackburn
2570 Vance Drive
Mount Airy MD 21771
410-875-2340
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 $45.00 | $________ |
| Associate Membership (open to non-citizens) | Annual Dues $45.00 | $________ |
| Second Household Member | Annual Dues $22.50 | $________ |
A contribution to the League further promotes our good work.
| A direct contribution to the LWV-Carroll County Co. | $________ |
| A tax-deductible contribution to the LWV-MD Education Fund | $________ |
|
TOTAL REMITTED MAKE CHECKS PAYABLE TO: LWV - Carroll CO. MAIL TO : LWV of Carroll County c/o Carol
Blackburn
|
$________
|