AAUW Dearborn

 Membership Application

 https://dearborn-mi.aauw.net/membership-application/ 

 

 If joining and paying by mail with a check: make the check payable to AAUW- Dearborn and send it with this completed form to: AAUW-Dearborn, P.O. Box 2498 Dearborn, Mi. 48123-2498.

If joining online, register at https://dearborn-mi.aauw.net. You may pay directly by credit card or send a check as directed within ten days to AAUW-Dearborn, P.O. Box 2498 Dearborn, Mi. 48123-2498.

 TODAY’S DATE: ______________________                                                                        

 BIRTH DATE (Month and Day): ____________________

 NAME (First, Middle Initial, Last):  _________________________________________________________

 STREET ADDRESS: ______________________________________________________________________

 CITY/STATE/ZIP CODE: __________________________________________________________________

 HOME PHONE: ________________________ WORK PHONE: __________________________

 CELL PHONE:___________________________EMAILADDRESS__________________________

 Have you been a member of AAUW in the past? Yes: ______ No: ______

 If yes what branch and for how many years? __________________________________________________

 Recruited by:______________________________________________________

 PLEASE LIST ALL DEGREES HELD, INCLUDING ASSOCIATE DEGREES:

 COLLEGE: ______________________________________________________________________________

 DEGREE: _____________________________________ YEAR: ______________________

 COLLEGE: __________________________________________________________________

 DEGREE: _____________________________________ YEAR: ______________________

 Branch Membership Category:

 BRANCH: $17 STATE: $15 NATIONAL: $74

 _____ $106 Affiliate Branch or Community Associate Member

 _____ $17 College/University Representative _____ $17 In-state Dual Member

 _____ $32 Out of State Dual Member _____ $32 Paid Life Member

 _____ $0.00 Honorary Life Member _____ $17

 STUDENT  ENROLLED IN AN AAUW College/University

 _____ $37.81 Student in a non AAUW College/University

 _____ $69 New Member or Lapsed Member (1st year fee only)

 Donation to a Fund/Program: __________________________________________

 *Higher Education Amt:____________ *Branch and Community Amt:___________

 *Marge Powell Leadership Award Fund Amt:_________________

  Total: Annual Dues and Donation Payment (one check) $_________

 Study & Interest groups: Check area(s) of interest to be contacted for  more  information.

 You may attend one meeting as a guest before officially joining AAUW-D.

 Book Sale Team//Online Sales_____ Publicity/PR_____ Epicureans _____Bridge_____              Book Clubs______Global Studies _____ New Member Events/Meet and Greet______    Community Outreach________Crafty Creations________                                              Other interests: ____________________________________________________________

 For questions or more membership information,  contact:  Mary R. Nameth,     V. P. Membership (nameth23@gmail.com or cell 313-378-2132).

******************************************************************* Treasurer Only –  Janice M. Frank: 870 Nightingale, Dearborn, MI 48128  Dues Check#__________ Date rec’d__________ Amt.__________                    Donation(s)  for________________________ Amt._________