Membership Form

MEMBERSHIP FORM

Please complete the following information and submit via website; or,
Print and Mail to Jan Stanley, Healdsburg AAUW Membership Chair,
437 W. Dry Creek Rd., Healdsburg, CA 95448-9122
or call her at: 707-433-7729

First name:		Last Name:
Address 1:		Address 2:
City:		State:	Zip
Phone (H):		Phone (Cell):
E-mail:		Fax:
College/University		State:	Degree earned/seeking: Year graduated/anticipated:
Membership in AAUW is open to anyone with an Associate Degree or its equivalent, or a Baccalaureate Degree from a regionally accredited institution. Student affiliates are enrolled in an Associate or a Bachelor degree program at an accredited two- or four-year institution.
	Membership is for:
Check Groups Interested In: Bridge Book Club Cultural Hiking Travel Food/Wine		What prompted you to visit Healdsburg AAUW website?
Please list your Degree Area/Major, employment and hobbies that you would like to share with other Members:
My name, phone number(s), and email address can be distributed to other Healdsburg Chapter AAUW members: Yes No
I have mailed my check to Jan Stanley, Membership Chair, 437 W. Dry Creek Rd., Healdsburg, CA 95448-9122 Yes No
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