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West Valley Membership Form

Women who live, work or conduct business in the West Valley are welcome to join. Non-members are welcome to attend two meetings before making a decision on becoming a member.
First Name:
Last Name:
Address:
City:
State: (ignore for non-US transactions)
Zip Code:
Country:
Email Address:
Confirm Email Address:
Preferred Phone:
Title (optional):
Organization (optional):
 If the address where you receive the credit card bill is different than above, please enter it here.
Credit Card Billing Address
 
Address:
City:
State:
Zip Code:
 
Charge Amount: Individual Full Year Membership or Continuing Membership Renewal - $90.00
Individual -New Member Joining April-June through Dec. 31 - $75.00
Individual -New Member Joining July-Sept. through Dec. 31 - $45.00
Individual -New Member Joining Oct.-Dec. through Dec. 31 - $22.50
Business/Organization Full Year Membership or Continuing Membership Renewal - $216.00
Business -New Member Joining April-June. through Dec. 31 - $162.00
Business -New Member Joining July-Sept.. through Dec. 31 - $108.00
Business -New Member Joining Oct.-Dec.. through Dec. 31 - $54.00
Nonprofit (501 C-3) Full Year Membership or Continuing Membership Renewal - $60.00
Nonprofit -New Member Joining April-June. through Dec. 31 - $45.00
Nonprofit -New Member Joining July-Sept.. through Dec. 31 - $30.00
Nonprofit -New Member Joining Oct.-Dec.. through Dec. 31 - $15.00
Pay via Credit Card  
Card Type:
Credit Card Number:
Credit Card Expiration (mm/yy): /
Name On Card:
C V V Value:
 
West Valley Women is a Private Organization.

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