Membership Form

2017-18 DUES PAYMENT FORM

Dues for New and Renewing members are $65
(National $49, IN State $7, SB Branch $9).

Dues for Paid Life members are $16
(represents State and Branch dues).

Please write check for amount of dues to: AAUW/South Bend Branch.

Mail the check and this membership form to our Treasurer: Nancy Harper 52304 Dorchester Court, Granger, IN 46530

Name___________________________________________________________

Address__________________________________________________________

Phone:  H____________  W_____________  E-mail________________________

Degrees & Institutions________________________________________________________

Professions/Fields of Study ___________________________________________ 

Amount Enclosed______________

I am a:
_____ new member
_____ renewing member
_____ transferring from a Branch in ____________________