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Membership Renewal

Dues are $40 for individuals, $20 for students, and $60 for a family.
Please complete this form and send it with your check, payable to LWVGB.
Mail to: Leonette Slay, Treasurer; 320 Albermarle Drive, Birmingham, AL 35226.

Name _____________________________________________________________________

Phone (h) ______________________________(w) _________________________________

___________________________________________________________________________
Street City St Zip

E-mail Address_______________________________________ Amount enclosed $_________

Questions? Call Nancy Ekberg at 967-2897 or e-mail her at nanekberg@aol.com