Member Application Form


 

Faculty and Professional Women's Association Membership Form

Name: _______________________________________________ Title: ______________________________

Department: __________________________________________ Telephone: _________________________

Mail Stop: ____________________________________________ E-mail: ____________________________

Dues ($10.00): __________ Scholarship fund donation (tax deductible): _____________________________


Please make checks payable to FPWA and return to Joan Mylroie at Mail Stop 9537.

 

*To print this application correctly change the "Page Setup" to landscape instead of portrait before printing.




For information about this page, contact Jacob Davis .
Last modified: Monday, 20-Sep-2004 13:31:01 CDT