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DEMOCRATIC WOMEN'S CLUB OF LEE COUNTY

Membership Application

NAME: ______________________________________________      Date: _____________________

ADDRESS: ___________________________________________      Apt. # ____________________

CITY: _______________________________________________      STATE: ____ ZIP: ___________

HOME PHONE: (___)________________  Best time to call: __________________________________

FAX: (____) ________________ E-MAIL: _______________________________________________

SPOUSE: _____________________________   NAMES of CHILDREN (include AGE or write ADULT

__________________________________________________________________________________

Voter Registration #: ____________________                    PRECINCT #: ________________________

County Commission District: ______________                    State SENATE District: _________________

CONGRESSIONAL District: _____________                    State HOUSE District:  _________________

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I have experience with an/or would be interested in helping on the following committee(s):

By-Laws ___    Historian ___    Legislature ___    Outreach ___     Sunshine ___

Campaign ___   Hospitality___   Membership ___ Program ___      Telephone ___

Fundraising ___ Issues ___        Newsletter ___     Scholarship ___

Are you willing to serve as an officer?       YES        NO   (circle one)    

What kind of work are/were you involved with? ______________________________________________

What clubs/organizations and/or volunteer activities are you associated with? (Use the back if necessary.)

___________________________________________________________________________________

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What do you feel is the most important topic that Democratic women should focus on -- and/or give program

suggestions: __________________________________________________________________________

QUESTIONS/COMMENTS: __________________________________________________________

___________________________________________________________________________________

MEMBERSHIP: $25.00 Annually (January -- December)  Please make your check payable to:

Democratic Women's Club of Lee County

P.O. Box 07117

Fort Myers, FL 33919

     We meet on the second Saturday of every month, at the HELM CLUB in The Landings, on McGregor Boulevard in Fort Myers, at 10:30 a.m. It is a luncheon, and you must RSVP by the Tuesday prior to the meeting; however, if you need to cancel, you must cancel by the Wednesday preceding the meeting -- or pay for lunch whether you attend or not.