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Join BPW/Waterford Today.

Personal Information:

Name:

Company name:

Work Address:

City, State, Zip :

Home Address:

City, State, Zip:

Please Indicate your preferred mailing address: Home    Work

Home Phone:   Work Phone:

Fax:         E-mail:

Birthday (just month and day)

Please join us today as a BPW/Waterford Member!

To become a member, please print and then return this form, along with  $94 (your annual dues) to:

BPW/Waterford Membership

Attn: Waterford BPW Treasurer

PO Box 55

Waterford, WI 53185

 

Professional Information:

Type of Employer:

Government      Educational

Professional Services   Health Facility/Med. Ctr.

Finance/Insurance    Retail Service

Retail Trade      Construction/Real Estate

Assoc./Non-Profit      Other

Communications        Self Employed

Manufacturing

Workplace Profile; Number of Employees:

1-10    11-50      51-100    101-500     over 500

If a BPW/USA Member assisted you in learning more about our organization, please list her/his

name here so we may thank her/him:

Name/Member ID (if known)