Membership Application Lake County Chapter CWA Membership Application/Renewal Contact Information Name* Email Address* Home Phone* ### ### #### Cell Phone ### ### #### Work Phone ### ### #### Employer/Occupation Mailing Address Line 1* Line 2 City* State* Zip* Areas of Interest* Scholarship Pear Festival Fundraiser Public Relations/Publicity Chapter Leadership Special Events New Member?* New Member Renewing Member Type of Membership* CWA Membership ($42.00) CWA + American Agri-Women ($72.00) CWA + Donation of $50.00 ($92.00) CWA + AAW + Donation of 50 ($122.00) Submit Submit
