App State Women's Club Membership Form

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Thank you for your interest in joining the App State Women's Club! Annual dues are $10.00

What is your first and last name? *

What is your telephone number (000) 000-0000? *

What is your email address? *

What BEST describes your affiliation with App State? (select one) *

Current Faculty Member

Current Staff Member

Retired

Graduate

I am a loved one (spouse, partner, or family member) of a current or retired faculty/staff member.

What App State department/college are you or your loved one affiliated with? *

What is your mailing address including city, state, and zip code? *

How will you pay the $10 annual membership dues? *

Cash - hand-deliver the Club treasurer or president (click here for contact information: https://asuwclub.wixsite.com/appstatewomensclub/leadership)

Check - make payable to ASU Women's Club and mail to 325 Poplar Summit, Boone, NC 28607

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