MEMBERSHIP REGISTRATION FORMYour LWV of Greater Cleveland membership provides you with three levels of League: National,State, and Local. The three levels work together for voter rights and governmental best practices.

When you join the League of Women Voters of Greater Cleveland, you may choose to affiliate yourself with one of ouractive local chapters. These are located in Bay Village, Cleveland, Cleveland Heights/University Heights, EastCleveland, Fairview Park, Hillcrest area, Lakewood, Rocky River, Shaker Heights, and Westlake/North Olmsted. If youdo not wish to affiliate with a local chapter, you are considered a Member at Large.

Please complete this form, print it outand return it with your check to: Membership Chair, LWV of Greater Cleveland

P.O. Box 5310Cleveland, OH 44101

____ $60 – Individual Membership

____ $90 – Household (1 additional person)

____ $5 – Student

____ I don’t wish to join or renew at this time, but ____ I’ve enclosed a donation to help the League ____ continue its important work.

Chapter Affiliation:

Membership Typeqq New Member qq Renewal

Any contribution above the basic $60 membership fee will be gratefully accepted as a non tax-deductible donation to theLWV of Greater Cleveland or designated chapter for operating expenses. Make your check payable to LWV of GreaterCleveland. Tax-deductible donations may be made with a separate check to the LWV of Greater Cleveland Ed Fund.

Name(s) (as you would like in print)

Street City State/Zip

E-mail Home Phone

Cell Phone Work Phone

Additional Contributions____ $40 – Belle Sherwin contributor____ $100 – Carrie Catt contributor____ Other Amount $____________________ Please send my contribution to____ affiliated chapter.____ Please keep my gift anonymous

Check Total: $___________________

You can also join/renew online atwww.lwvgreatercleveland.org/join