Membership
Form
Membership
Year: _________
(Click here for Word document membership form.)
Check
your membership level:
Regular
Membership
$
25___
Wildflower Membership
$
50___
Ann Richards Membership
$100___
Bluebonnet
Membership
$250___
Ladybird
Johnson Membership
$500___
Student/Senior
Membership $
15___
Name:
_____________________________________________________________
Address:
___________________________________________________________
City:
___________________________ State:
_______
Zip: ________________
Precinct: ________ (Check your voter
registration
card.)
Email
address: _______________________________________________________
Home
phone: ______________________ Cell phone: _______________________
Occupation:
_________________________________________________________
*I would like to enclose
an additional $
_________ for the TDW Annual Scholarship Fund.
Total
Enclosed: $ _________________
($10
of every membership goes to TDW of Texas.)
Please make check
payable to TDW and mail to:
TDW