I'd like to join LWV South Tonka

Name:	______________________________________
Address:	______________________________________
City/State/Zip:	______________________________________
Phone:	( _____ ) _____ - _________
Email:	______________________________________

Individual Dues: $55.00

Household Dues: $82.50

Student/Limited Income: $25.00

Please print, fill out, and mail with a check made out to LWV South Tonka to: