Membership Application | Flagler County (FL) Branch

American Association of University Women – Flagler Branch
Membership Application

Please submit this form and mail $99* dues check to:

AAUW Flagler
P.O. Box 354873
Palm Coast, FL 32135-4873

*Dues include affiliation at the National, State and Local Branch levels.

Name*
First Last
Maiden/Degree Name
Address*
City, State, Zip*
Local Phone*
Office Phone
Cell Phone
E-mail Address*
Birth Date*
MM slash DD slash YYYY
College/University/Nursing Program*
Include address, degree(s) year, and major studies.
Additional College or University
Include address, degree(s) year, and major studies.
Profession*
Current Employment and/or Volunteer Work*
Introduced to AAUW by:
Membership in other Branches
List branch, year, and offices held.
Check areas of interest:
- Fund Raising
- Telephoning
- Hostessing
- Voter Education
- Literature Group
- Creative Writing
- Public Policy
- Girl's Book Discussion Group Leader
What areas of interest would you like to see us pursue? Give us your ideas...
Examples: play reading, film discussion group, go-green, international relations, leadership programs, clerical/computer, sports, community projects.
Name
This field is for validation purposes and should be left unchanged.