Wheaton-Glen Ellyn Branch of AAUW New Member Form 2009–2010

New Member Dues:

Through 12/31/09

Effective 1/1/10

Association

$49 ($46 tax deductible)

$24.50 ($22.50 tax deductible)

Illinois Division

$10

$10.00

Wheaton-Glen Ellyn Branch

$19

$19.00

Total

$78

$53.50

 In addition to my Member Directory Listing, include me in the Member-to-Member Business Networking Section of the Directory and include a link to my business on the Branch Website.

$_______ (Enter $2.00 or $0)

If yes, fill in your business networking details below.

$_______   Total Payment

Make check payable to Wheaton-Glen Ellyn AAUW.

Mail to:   Judith Sims, 426 Sandhurst Circle, Glen Ellyn, IL 60137

Member Referral:  Who referred you to AAUW?

___________________________ (Current Member’s Name)

TWIGS Newsletter Options:

(Circle One)

Send me the Twigs Newsletter by:

E-Mail U.S. Mail.

Member Directory Listing (Please Print)

Name:   _________________________________________

_______________________________________

Last Name

First Name

Address: _______________________________________________________________________

City:  ________________________________________

Zip Code:  ___________________

Tel. Nos.: ____________________

___________________

____________________

_________________

Preferred for Directory

Home

Work

Mobile

E-mail(s): _____________________________________

________________________________________

Preferred (for TWIGS)

Other

University/College:

Degree

Major

Year

__________________________________________

_______

_________________________

________

__________________________________________

_______

_________________________

________

__________________________________________

_______

_________________________

________

Member-to-Member Business Networking Directory Listing

(Please Print)

Name:  ___________________________________________

_______________________________________

Last Name

First Name

Profession or Title: _________________________________________________________________________

Company: _____________________________________________________________________________

Website: _____________________________________________________________________________

Address: _____________________________________________________________________________

City: __________________________________________________________

Zip Code:  _____________

Tel. Nos.:  _________________________

___________________________

_______________________

Work

Fax

Mobile

E-mail(s):

_________________________________________

_______________________________________

Work

Other

NOTE: Networking information received by August 1, 2009 will be included in the 2009-2010 Member Directory. After August 1, networking information for new members will be published in TWIGS.