Join the League Form

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

League of Women Voters of Fluvanna County
P.O. Box 423
Palmyra VA 22963

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 $______________________

($50.00 one member. $75.00 two members same household. Dues are not tax deductible.. Please make out the check to: League of Women Voters of Fluvanna County )

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

____________________________________________________________

____________________________________________________________

Please mail your application form with your check to :

LWV Fluvanna County Treasurer

3 Landslide Court

Palmyra VA 22963

Comments, suggestions, questions? Contact our webmaster. Last revised: October 30, 2008 06:31 PDT.

© Copyright League of Women Voters of Fluvanna County, Virginia. All rights reserved.