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| Name(s): | |||||
| Address: | |||||
| City: | State: | Zip: | |||
| Phone: | E-mail: | ||||
| Amount enclosed: | -Individual: $48      -Family: $71      -Student: $24 | |
| Interests: (Check all that apply) | ||
| Voter Service (Voter Education & Candidates' Forums) | Civics Education | ||||
| Local Government Issues | Natural Resources/ Environment | ||||
| Privatization of Government Services | Civil Liberties | ||||
| Reapportionment/ Redistricting Reform | Campaign Reform | ||||
| Social Policy | Justice System/ Judicial Independence | ||||
| Other: | |||||
Mail completed form, along with dues check to:
LWV Alachua County/ Gainesville
P.O. Box 15285
Gainesville, FL 32604-5285Please make checks payable to: LWV Alachua County/ Gainesville.