| AAUW WINDWARD BRANCH MEMBERSHIP APPLICATION 2010-2011 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, 2011) (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 membership chair, Sue Schneiderman at 262-8383 or e-mail her at kbaynurse@hawaiiantel.net or contact treasurer Leslie Briggs at 262-0720 or e-mail her at Briggs002@hawaii.rr. com. 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. ________________________________________________________________________ Treasurer’s Record: Date of receipt of application:_________________________________________ Amount submitted:___________________________ Type of Membership______________________________ |