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WEST SEATTLE DEMOCRATIC WOMEN
MEMBER INFORMATION FORM
MEMBER NAME: _______________________________________________________
Address (City, State, Zip): _________________________________________________
Home Phone: _________________ Cell Phone: ___________________
E-Mail Address: _________________________________________________________
Meeting Reminder Method: _____Home Phone _____E-mail _____Cell Phone
Legislative District: _____ Precinct #: _____
GET ACQUAINTED: Join a Committee (Circle if one of the following interests you!)
Outreach Membership WS Timebank
Facebook Website Encouraging Girls into Politics
Greeter Sign-in Table
________ ___________ __________
* What are your suggestions for speakers, discussions, forums, events for presentation by WSDW ?
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* What are your primary political and community interests?
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
* Do you have skills, experiences or interests that you might contribute to WSDW to help everyone learn more about pertinent political and community issues?______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
* How could WSDW help you learn more about pertinent political and community issues?
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* Are you willing to provide a ride to the meeting for another person? ____________________________
* Do you need a ride to the meeting? ______________________________________________________
* Do you have any special needs you would like us to be aware of in order to best accommodate your attendance at the WSDW meetings?
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Thank you. *****DUES*****
Sincerely, Date: ________________________
The WSDW Executive Board Amount Paid: __________________