VOLUSIA COUNTY

 

 

MEMBERSHIP APPLICATION

(July 1 – June 30)

 

Please print out and complete this application.  Send it with your membership dues to:

 

LWVVC

Post Office Box 9418

Daytona Beach, FL  32120

 

(  )           Individual $50.00

(  )           Family Membership $70.00

(  )           Student Membership $25.00

 

Name: 

 

Street Address: 

 

City/State/Zip: 

 

Home Phone: 

 

Work Phone: 

 

e-Mail Address: 

 

Today’s Date: 

 

Special Interests: 

 

 

 

 

 

 

Employer: 

 

 

 

 

Last updated June 16, 2004