Member Registration Form Birthday*Month & Day MM slash DD slash YYYY Date of Submitted Application* MM slash DD slash YYYY Your Contact InformationName* First Last Address* Street Address City ZIP Code Mailing Address (If Different) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Home Phone*(###)###-####Cell Phone(###)###-####Education InformationCollege / University / Institution*City/State*Degree/Major*Year Graduated*City & State of Your College/University/Institution(If you received a degree from a second institution)Major(Your second major)Degree & the Year You Graduated(Your 2nd degree)Prior AAUW MembershipPrevious AAUW membership?* Yes No Under what name?What branch?City/State?Years of membership?Occupationcurrent or pastCommunity Activities or InterestsThese activities help new members meet people who share a similar interest and make a connection with our branch. Check those that you would like more information about:Interest Groups: Art Interest Beading Group Book Group Bridge Wine Appreciation Food & Fun Movie Mavens Needlework Out & About (events in the region) Out to Lunch Papercrafting Spirited Folks Theater Goers What special event and/or committee would you be interested in joining: Equal Pay Day (April event) Girls Rock! (February STEM) Technology Committee Kitchen Tour (October fundraising event) Branch Programs Committee Help a Board Member: Serve on the Scholarship Committee Assist the newsletter editor Keep branch’s website up-to-date Keep branch’s Facebook page up-to-date Set up equipment at branch meetings Help with branch publicity Assist with decorating tables for brunches Help with fundraising event Educate members about public policy issues Serve as a liaison to Rogue Community College Have computer skills to help with emailings Assist with event planning and/or fundraising Send greeting cards to members Assist with finance or budget Other skills/talents you can share: Make check payable to AAUWMail check to: Treasurer P.O. Box 1812 Grants Pass, OR 97528PhoneThis field is for validation purposes and should be left unchanged. Δ
