First Name *

Last Name *

Email *

Phone *

Address (Street, State, Zip) *

Which subdivision do you live in? (if applicable)

Which committee would you like to serve on? (Optional for Associate Members, but we'd love to have your input!)

Community Outreach

Juniorettes

Membership

Philanthropy

Ways & Means

Are you interested in participating in any special projects?

Breakfast with Santa

Community Improvement Project

Grants/Scholarships

H.O.P.E. Community Clothing Closet

Local Politics Forum

Mental Health Symposium

Social Media/Website

How will you pay your membership dues? *

Credit card (next screen)

Check

Zelle

After submitting this membership form, you will be redirected to pay your $75 annual dues via credit card. To pay via check or Zelle, contact ljwctreasurer@gmail.com for instructions.