.Celtic
Women
International
CWI Membership Application
Form
(Please
Copy, Print and Snail-Mail or fax to Listed Address or fax number)
- PLEASE PRINT
Celtic Heritage (if applicable):_________________________________________________________
HOME ADDRESS:
Street:___________________________________________Apt#:___________
CITY or TOWN:___________________________________________________________
STATE:______________________ZIP:_____________COUNTRY:_______________________
HOME PHONE
:(_______)_______________________________
BUSINESS PHONE:(_______)_____________________________EXTENSION:__________
I prefer to
be called at ___Home ___Work Best time: ________FAX NUMBER(____)__________
E-Mail Address:_________________________________________
Signature of Applicant:_______________________________Date:__________________
I recommend
you send an application for CWI membership to the following people:
(please print)
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
2 WAYS TO PAY:
1. By FAXING your application with credit card information to 414-257-3705
Tick Payment Method:____Check ____Money Order ____ Visa ____ Mastercard ____ Discover
Credit card
#:___________________________________________
Expiry Date:_________________________________________
Name as Shown
on Card:__________________________________
Mailing address
_________________________________________
City, State,
Zip Country Code _______________________________
Charge cards will currently reflect
the busines name: JETTE/KEHOE
2. By MAIL Make checks or money order payable to Celtic Women International and mail to:
Celtic Women International; PO 371174, Milwaukee, WI 53237-2274 USA
Email:
Membership is open to all persons who support the mission of Celtic Women International,Ltd.
Categories of Membership:
- Regular Member: Dues: $25 annually, or 5 years for $100. Will receive a Membership card and a subscription to the CWI quarterly newsletter; eligible to become a Director and Officer.
Student Member: Dues $10 annually. Must be enrolled full-time in an accredited college-level program. Send a copy of identification showing student status. You will receive a Student Membership card and a subscription to the CWI newsletter.