Join the League Form

League of Women Voters^®
of Mississippi, Inc.

Please print out this page and fill out this Membership Application Form and mail with your check to:

League of Women Voters of Mississippi, Inc.
League of Women Voters of MS
PO Box 55505
Jackson, MS 39296-5505

Membership Application Form

Name________________________________________________________

Name(s) of additional member(s) in household__________________________

Address______________________________________________________

City_______________________________ Zip Code __________________

Phone (home)___________________ Phone (work/day)_________________

Cell phone_______________Email address____________________________

Amount enclosed $______________________
(MAL $36.00 one member. MAL $54.00 two members same household. Other available membership categories: Student: $20.00 / Fifty-year and longer member: free / LWV Jackson Area, individual: $50.00 / LWV Jackson Area, household: $67.50 / LWV Gulf Coast, individual: $40.00 / LWV Gulf Coast, household: $60.00. Dues are not tax deductible. Please make out the check to: League of Women Voters of Mississippi, Inc. )

Comments (e.g. interests, how you heard about the League)

____________________________________________________________

____________________________________________________________

Be sure to indicate for which type of membership you are applying:
_____ MAL one member: $36.00
_____ MAL two members same household: $54.00
_____ Student: $20.00
_____ Fifty-year and longer member: free
_____ LWV Jackson Area one member: $45.00
_____ LWV Jackson Area household: $67.50
_____ LWV Gulf Coast one member: $40.00
_____ LWV Gulf Coast household: $60.00

Comments, suggestions, questions? Contact our webmaster. Last revised: August 7, 2010 22:15 PDT.