FirstName LastName
Street Address
City
Zip
Office Phone (XXX-XXX-XXXX)
Home Phone (XXX-XXX-XXXX)
Ext.
Email Address
Elected Office, if any
 Term Ends
Jurisdiction
Employer
Position/Occupation
Check the appropriate box below
Associate Member $25
Regular Member $35
 Emerita Member $25
OR
Emerita/Assoc Dues + 3-Breakfast Package
$75 ($10 savings on breakfasts)
Regular Dues + 4-Breakfast Package
$100 ($15 savings on breakfasts)
I will pay by (choose one):
When you are satisfied with your input, click
Submit. You can start over by clicking Reset
Membership for 2011-12
Membership Benefits
Get reduced price for
networking breakfasts and
workshops!
cation of additions to  
website, such as when
website, such as when
reservations are open for
networking breakfasts and
other events!
To join WON, fill out the form below and submit it electronically;
then mail your check to us at the address at the lower left
OR
Fill out the form, submit it to us electronically, then the confirmation will give
give you a link to our PayPal page where you may pay your dues.
OR
along with your check to us at the address at the lower left
                                                                         
2011-2012 WON Membership Form
Regular Member
Current elected official
Emerita Member
Former elected official
Associate Member
Appointed officials, precinct
delegates,  other members
of the public--can serve on
board
Women Officials' Network
Women Officials' Network
PO Box 404
Birmingham MI 48012-0404
248.335.7637
Contact Information
© Copyright Women Officals' Network 2011