Membership Test Form PAYPAL Membership Form_PAYPAL Name * Street Address * City * State * Zip * Phone * Email Is this a… * New Membership Renewal How would you like to pay? * Check Card/Paypal Note: If you pay by credit card, you will be charged an additional 3% fee to offset credit card processing. If you made a donation in addition to paying your membership fee, you will not be charged the 3% fee. Would you like to make a donation? * Yes No How much would you like to donate? $10 $20 $50 OtherOther Annual Membership Type (Dues are NOT tax deductible) Single ($70) Household (2 adults at the same address, $105) Student (Full or Part Time, $0) When paying by check, please print out the form emailed to you upon completing this form and mail it with your check to: LWVGGRA PO Box 174, Belmont, MI 49306 Annual Membership Type (Dues are NOT tax deductible) Single ($70) Household (2 adults at the same address, $105) Student (Full or Part Time, $0) Annual Membership Type + 3% Fee (Dues are NOT tax deductible) Single – $72.10 ($70 + $2.10) Household – $108.15 (2 adults at the same address, $105 + $3.15) Student (Full or Part Time, $0) Comments/Involvement Interests If you are human, leave this field blank. Submit
