Working for government that works for all

MEMBERSHIP APPLICATION

Leelanau Independent Women for Democratic Action
welcomes you!

Our membership fees are $5 to $100 -- you decide!


To print this form, click on your browser's "print" button.  Then fill out and return to:
LIWDA
P. O. Box 151
Glen Arbor, MI   49636

along with your membership fee.

NAME_____________________________________________________________________________

ADDRESS__________________________________________________________________________

       ______________________________________________________________________________

CITY, STATE, ZIP____________________________________________________________________

PHONE___________________________________________

EMAIL_____________________________________________________________________________

AMOUNT ENCLOSED_______________________________  
(Please make check payable to: LIWDA)
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