MEMBERSHIP APPLICATION – For NEW Members ONLY COUNT ME IN! I wish to join NOW and commit myself to take action to bring women into full partnership in the mainstream of American society now, exercising all privileges and responsibilities thereof in truly equal partnership with men. NAME _________________________________ PHONE ( ) ______________ ADDRESS ______________________________ E-MAIL ___________________ CITY ________________________________STATE ________ ZIP ___________ VOLUNTEER - Please check all areas of interest __ Answering NOW Telephone * __ Phone/Outreach __ Write articles for publication __ Demonstrations/Protests __ Fund raising __ Mailings __ Lobbying ___ Escort SAT AM Other (please specify _____________________________________________________________ *Answering NOW Telephone: When are you available to volunteer? Please circle all that apply Daytime: M T W Th F Sat Sun Evening: M T W Th F Sat Sun In what areas would You like to lead Westchester NOW to become more active? _____________________________________________________________ Thank you for your comments!		Clip and Mail to: Westchester NOW c/o Deborah Zipf, Treasurer 10 Stewart Place, PH-AE White Plains, N.Y. 10603
National, State & Local Dues: $40 Regular Dues $25-39 Reduced Dues Amount Enclosed: _________	To be completed by Chapter Treasurer only. Chapter Number NY0540 Total National Dues Accompanying this form _____________