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Name________________________________Phone:(H)______________(W)_______________
Address_______________________________________________________________________ Zipcode___________________County_____________E-Mail___________________________ Second Household Member___________________________________________ |
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Member (Open to men and women who are United States citizens and age 18 or older) |
Annual Dues $50.00 | $_______ |
| Second Household Member | Annual Dues $25.00 | $_______ |
A contribution to the League further promotes our good work.
| A direct contribution to the LWV-Washington Co. | $_______ |
| A tax-deductible contribution to the League affiliate, the Maryland Voters Education Fund. (Please remit with separate check made payable to MVEF.) | $_______ |
| TOTAL REMITTED (dues and contribution to LWV-Washington County payable to LWV-Washington County Unit) | $_______ |