Please click on link above to download the Membership Application form.
MEMBERSHIP APPLICATION
“Educate a woman, and you educate a family.”
Name (Print) ______________________________________________________________________
First Last
Address __________________________________________________________________________
(Please include Apt. #) City State Zip Code
Home Telephone ( ) __________________________ Work Telephone ( ) _____________________
Cell # __________________________________ Email Address _____________________________
Employed By ______________________________Title ____________________________________
(Or School Attending) (Or Grade/Year, e.g. Sophomore)
Work Address _____________________________________________________________________
(Include Dept., Room #, or Suite#)
Work Address _____________________________________________________________________
(Please Attach Your Business Card) City State Zip Code
NOTE: Application for Membership is subject to the approval of the Executive Board.
|
MEMBERS (MEN & WOMEN – NEED NOT BE HISPANIC ) |
|
| Individual (Employed Full Time) | [ ] $60.00 |
| Employed Part Time, Unemployed, Retired or Full Time Student | [ ] $30.00 |
| Corporation or Group | [ ] $500.00 |
Membership entitles you to $100 discount off of your $180 Gala ticket. As a Member, you pay only $80 to attend our Gala Dinner Dance at the Marina Del Rey in the Bronx.
Contribution: $_____________________Total Enclosed: $___________________________________
(NO AMOUNT IS TOO SMALL.)
Please make check payable to: NY LEAGUE OF PUERTO RICAN WOMEN, INC.
& mail to: NY League of Puerto Rican Women, Inc.
P. O. Box 60337, Brooklyn, New York 11206-0337
Applicant’s Signature ______________________________ Date: _____________________________