Please mail this form and checks to:

Mimi Snyder, Membership Chair,
330 Laurel Lane, Haverford, PA 19041

_________________________________________________________________________

NATIONAL MUSEUM of WOMEN in the ARTS, Pennsylvania State Committee

In order to be a member of the Pennsylvania State Committee, you must be a member of NMWA. Annual NMWA membership dues: $40. Both NMWA and NMWA-PA are non-profit organizations.

___ I am a current NMWA member; my NMWA member # is ____________*
(If you are not yet a member of NMWA, please contact NMWA Member Services at: 866-875-4627 or http://www.nmwa.org/support/membership.asp to join.)

___ Yes, I would like to join the PA State Committee of NMWA

___ $50.  Pennsylvania Patron

___ $20.  Member - annual dues


Name:                   _______________________________________________

Address:                _______________________________________________

                             _______________________________________________

Phone:  (_____)_______________   E-mail _______________________________**

Please make checks payable to PA State Committee of NMWA. 

*Your member number is located on your NMWA member card. If you do not have this number, please contact Ellen Pollak, NMWA National & International Committees Manager, for this information.

**To help reduce costs on future notices, please provide e-mail address.  All information is private and confidential.