Membership Form 2022

Please fill out the form. Upon submission you will be prompted to download your form as a PDF. Please print and send, along with your check (made out to LWVMI), to:

LWVGGRA
PO Box 174 
Belmont, MI  49306-0174

Membership Form_Check

Name *

Street Address *

City *

State *

Zip *

Phone *

Email

Is this a… *

New Membership

Renewal

Annual Membership Type (Dues are NOT tax deductible) *

Single ($70)

Household (2 adults at the same address, $105)

Student (Full or Part Time, $0)

How would you like to pay?

Check

Card/Paypal

Comments/Involvement Interests

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