Your Name (required)

Partnership Application:

Name of Organization:

Address of Headquarters :

Street /Postal:

Box

City:

State/Prov./Country:

Zip Code:

Web site address:

Phone number:

Your Email (required)

Subject

Organization’s Mission Statement:

Web site address:

Membership Dues: (circle one)
Individual Membership: $40.00/year (U.S.)
Corporate Membership: $120.00/year. (U.S.)
Membership includes: quarterly newsletter featuring new member groups; webpage advertising your organization; and a member directory for networking.
www.womenforlifeintl.com