From: [email] 
To:joinwnba@juno.com 
Subject: WNBA Membership Form - [required-Name] 

PERSONAL INFORMATION -------------------- 
Name: [required-Name] 
Home Street Address: [required-HomeAddress] 
Home City: [required-City] 
Home Phone: [HomePhone] 
Position: [Position] 
Organization: [Organization] 
Work Street Address: [OrgAddress] 
Work City: [OrgCity] 
Office phone: [OfficePhone] 
Fax Number: [Fax] 
E-mail Address: [email] 
Send mail to my [Mailto]. 
List my [Directory]. 
I am a [MemberStatus]. 

PARTICIPATION ------------- 
I would be willing to volunteer for committee work 
or provide other help: 
[%s ,Participation] 

PROGRAMS -------- 
I would like WNBA to address in its programs: 
[Programs] 

NETWORKING ---------- 
I would like to be listed in the Networking section of the 
WNBA directory in these categories which best describe my work: 
[%s ,Networking][Networkin_other] 

Describe the main activities of your work: 
[Main_Activities] 

List Names and Addresses of People who might be 
interested in receiving WNBA membership information: [Referral] 

MEMBERSHIP FEE -------------- 
Contribution based on income: [Fee] [Corporate_Membership] 

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Please, mail a check for [Fee] payable to Women's National Book Association/Washington 
Chapter together with a copy of this form to:Ann Happ, Membership Chair, 9113 
Cherry Tree Dr., Alexandria, VA 22309