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Date: ________________
Dr./Ms./Miss/Mrs./Mr.
Name:________________________________________Birthday: ____/____
Month/Day
Address:_________________________________________________________
_________________________________________________________
City: ________________________ State: _______
Zip: _________________
Phone (H)_________________ (W)_________________(C)________________
E-Mail:__________________________________________________________
College or University Degrees:
College/University___________________________________
State: ________
Degree ____________________________________________
Year: ________
College/University___________________________________
State: ________
Degree ____________________________________________
Year: ________
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| Membership Dues Include: |
Additional Donations: |
| Association $49 |
EF: $____________
(tax deductible) |
| State
10 |
LAF: $____________ (tax deductible) |
| Branch
16_ |
____________________ |
| Total
$75 |
Total $_____________ |
Mail application and make check payable to: AAUW Seattle
Attn: Pauline Barrett
11436 SE
208th St., #183
Kent,
WA 98031-4138
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