League of Women Voters
 of Blount County

 Online Membership Application

Please provide the following contact information: (* required)

First Name* Last Name*
2nd First Name 2nd Last Name
Additional Family Names
                          
Mailing Address*  
City* State*       Zip Code* 
E-mail*   Phones  Home
              Cell
 
Membership Type
 (Select One or More)		 Individual Membership $60.00 per year
Each Additional Family Member $30.00 per year
Student Membership $30.00 per year
  TOTAL MEMBERSHIP DUES
 Note: Membership dues are not tax-deductible
 
Optional Donations
We rely on donations and membership dues to conduct our programs.
If you would like to make a donation to help us provide educational services, you may donate to the League of Women Voters of Tennessee Education Fund (LWVTNEF). Your donation is fully tax-deductible where permitted by law.
If you want to help us advocate on the issues you care about, make a donation to the League of Women Voters of Blount County Operating Fund. This contribution is very important to us but is not tax-deductible.
 
Volunteer Interests:
 I / We are interested in volunteering as follows:
(1) Whatever is needed (2) Voter Registration
(3) Candidate Forums (4) Board Watching
Other
Interests

Enter today's date -- mm/dd/yy