STUART AAUW Membership  Form

 Dues are 95.00 annually.  Please make check payable to Stuart AAUW. Please submit dues to Faith Englund 2383 NW  Cove View Dr.  Stuart, Florida 34994. ( if you are a dual member dues are 26.00)

Name:_______________________________ Membership ID:_______________
Nickname____________________________

Membership Type:
Annual ___   Life_____ Honorary Life_____ Dual*_______*Primary Membership________ in state________   Member At Large? ____YES____NO

Email:_____________________________
Cell Phone:_________________________

FLORIDA CONTACT INFORMATION

ADDRESS___________________________________

CITY_______________STATE_______________ZIP CODE___________

HOME PHONE_________________________
WORK PHONE______________________________

ALTERNATIVE ADDRESS
DATES  FROM:____________________TO:______________
ADDRESS___________________PHONE______________CITY______________________ STATE_____________   ZIP________________

COLLEGE DEGREE INFORMATION… Please include College, Degree, Year  (This must be completed)

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