League of Women Voters of Nebraska Member-at-Large Form

Name *

First

Last

Membership Level *

Students do not need to proceed to a payment option after clicking submit.

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Primary Household Member's Full Name *

(If Applicable) Add-on Household Member's Full Name

Referral

Tell us about yourself! What are your fields of interest? (Volunteering, work, etc.)

Payment Agreement *

I agree to complete this process by purchasing this membership with PayPal OR By sending in a check in the mail.

Payment Options

Paying by check has no fees, general memberships are – $40 by check and Household memberships are $60 by check.

Please make checks payable to the League of Women Voters of Nebraska and mail to:

P.O. Box 29816

Lincoln, NE 68529

If you have any questions, please e-mail: membership@lwvnebraska.org. Thank you!