AMSTERDAM-GLOVERSVILLE-JOHNSTOWN AAUW
                                        2010-2011 Membership Renewal Form

Name: ________________________________________________

*****PLEASE NOTE ANY CHANGES AND COMPLETE THE  PAGE BELOW*****
Address: ________________________________________________
________________________________________________
Phone: ________________________________________________
Institution(s), Degree(s), and year(s) of graduation:
________________________________________________
Email Address: ________________________________________________

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Please Check One of the Following:
_______ I have enclosed $_______* for dues before June 1,  2010. *($ 64)

_______I have enclosed $_______ ** dues after June 1, 2010.    **($70)                                
                                                

(*Subject to revision re AAUW National and State assessments.)

_______ I have enclosed $_______* for dues as a Life Member.
(*To become a life member one pays 20 times the current national dues plus the current
yearly state and local dues yearly)

________ I am resigning membership in AAUW.
My reason(s) is/are as follows:
____Family obligations ____Moving out of the area ____Dues amount ____Meeting topics
Other (please specify):_________________________________________________________

       
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If you are interested in serving on a committee, please indicate by putting an X by the
name of that committee.   
Committee descriptions are available from membership chairperson.

____Program                 ____Community Outreach         ____Finance         
____Membership         ____Historical

____Nominating         ____Cultural         ____Public Policy         ____International Issues   
      ____Diversity

____ Educational Equity/Scholarship         ____LAF - Legal Advocacy Fund         ____
Sister to Sister


***Make your check payable to AAUW and send this form along with your check to:

             Barb Nigro
484 Co. Hwy. 122
Gloversville, NY 12078

Thank you in advance for your prompt attention to this matter.