Lincoln County 

Membership Form

Please print out and complete       The membership year begins October.

Name________________________________ Phone______________  Email_________________

Address_________________________________   City______________   Zip_____________

 
___     I am a new member 

___       I am renewing my membership.             

Annual Membership Dues:  $50 (Individual)    $75 (Household)                     Dues are not tax deductible.     

Amount Enclosed$_________    

Please make checks payable to: LWV of Lincoln County                   

 
I wish to contribute an additional amount to:

     LWV  Lincoln County*                $________
                * Contributions assist LWV Voter Service activities and education projects.

LWV Oregon Education Fund**       $________
               ** Contributions to the LWV United States and LWV Oregon Education Fund are tax deductible.  
                     Enclose a separate check payable to LWVOREF.

Please print out this form, and...

Mail to:  Jamie Auborn, 171 NW 58th St., Newport, OR 97365 

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