Yes, I want to join the League of Women Voters of Montgomery County. I enclose:
		$ 20	STUDENT, one-year membership
		$ 40	INDIVIDUAL, one-year membership
		$ 60	HOUSEHOLD, one-year membership (for two members who share an address)

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Name/Names

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Address

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City, State, Zip

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Telephone numbers

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E-mail Address

Please make your checks payable to the LWV of Montgomery County. Mail this application form and your check to:

LWVMC
P.O. Box 101
Crawfordsville, IN 47933