Join the League Form

League of Women Voters^®
of Greater Lafayette

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

League of Women Voters of Greater Lafayette
P.O. Box 2085
West Lafayette IN 47996

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. Other available membership categories: Students: $25.00.
Dues are not tax deductible. Please write your check to: League of Women Voters of Greater Lafayette

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

____________________________________________________________

____________________________________________________________

Additional contribution: Make a non-tax deductible contribution to the League of Women Voters of Greater Lafayette supporting organizational and advocacy activities.
Non-tax deductible contribution: $______________
Fern Weber Fund: This fund is available to assist with partial payment of membership dues. If you would like more information, please note in Comments above, or contact the League at league@leaguelafayette.org
Non-tax deductible contribution to the Fern Weber Fund to assist members with dues: $_______________
Indiana Education Fund: Make a tax deductible contribution to support the local League's non-partisian citizen education efforts.
Write a separate check to Indiana Education Fund and mail to

League of Women Voters of Greater Lafayette
P.O. Box 2085
West Lafayette, IN 47996

Tax deductible contribution to the Indiana Education Fund: $_______________

We are a 501(c)(4) organization.

Comments, suggestions, questions? Contact our webmaster. Last revised: January 19, 2012 13:09 PST.