MEMBERSHIP APPLICATION  2012-2013  NAME____________________________________________________________    DATE____________________ ADDRESS____________________________________________________________________________________ CITY__________________________________    STATE___________________    ZIP______________________ PHONE________________________________    DATE OF BIRTH_____________________________________ E-MAIL_____________________________________________________________________________________ EDUCATION: College/University                            State          Major                                     Degree                          Date of Degree ___________________________     ____         ___________________         ___________                ___________ ___________________________     ____         ___________________         ___________                ___________ ___________________________     ____         ___________________         ___________                ___________ ___________________________     ____         ___________________         ___________                ___________ Member who brought you_______________________________________________________________________ MEMBERSHIP/DUES CATEGORIES (please circle amount) Windward Branch membership total:  $75/year (July 1 through June 30)       Membership includes National dues:  $49 ($46 is tax deductible), $10 State dues, $16 Branch dues Dual membership in another branch: $10 Interest Group membership: $75 For questions contact Sue Schneiderman at 262-8383 (kbaynurse@hawaiiantel.net) Make check out to AAUW Windward Branch and mail to Sue Schneiderman 90 Kailuana Place, Kailua, 96734       Treasurer's Record:   Application Date: _______________  Amount: ________________  Category: _______________