AAUW WINDWARD BRANCH MEMBERSHIP APPLICATION
                                                                    2009-2010


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:  
$69/year (through June 30, 2010)
(Membership includes National dues, $49 ($46 tax deductible); State dues, $10; Branch dues $10
Dual membership in another branch,
$10 /year
Interest Group membership, $69/year

If you have questions, please contact either membership chairs, Sue Schneiderman 262-8383
or Flo Hayslip 262-8300, or treasurer
Leslie Briggs at 262-0720
Please complete this form and submit it with a check for the amount appropriate for your membership category.
Make check out to AAUW Windward Branch and mail to:
Sue Schneiderman 90 Kaiulana Place, Kailua, HI 96734
or e-mail to kaybaynurse@hawaiiantel.net

________________________________________________________________________

Treasurer’s Record:
Date of receipt of application:_________________________________________
Amount submitted:___________________________
Type of Membership______________________________