APPLICATION FORM
Application for Membership in AAUW, Bethlehem Branch
Name: (last, first, maiden) ________________________________________
Address: _____________________________________________________
City/State/9-digit ZIP: ___________________________________________
Phone: (H) _________________________
(W) _________________________
E-mail: ____________________________
College/University: __________________________________
State:_____________________
Degree: __________________________
Year: ____________
( ) Occasionally AAUW's membership list is
made available to carefully screened
companies and organizations. Check here if you do not want your name included
on the list.
Dues 2008 - 2009
$75.00
Please make check payable to "Bethlehem Branch, AAUW"
Send application form and dues to:
Berry Richards
2324 Overlook Drive
Bethlehem PA 18017