UNIONTOWN BPW

MEMBERSHIP APPLICATION

MEMBERSHIP APPLICATION

 

UNIONTOWN BUSINESS & PROFESSIONAL WOMEN’S LOCAL ORGANIZATION

of the PENNSYLVANIA  FEDERATION OF BUSINESS & PROFESSIONAL WOMEN.

 

 

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NAME:    LAST                           FIRST                           MIDDLE


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IF MARRIED,HUSBAND’S NAME

 

 

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ADDRESS PHONE NO.

 

 

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BUSINESS ADDRESS PHONE NO.

 

 

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EMPLOYED BY TYPE OF BUSINESS POSITION HELD

 

 

 

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HOBBIES AND OTHER INTERESTS

 

 

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APPLICANT’S SIGNATURE                                    BIRTH DATE

 

 

SPONSOR EMAIL_____________________________

 

DUES $25.00  (Checks payable to the Uniontown BPW)  DATE

 

Send Application and Check to the Uniontown BPW Treasurer:

Kathy Cohen

242 Brown Blvd.

Uniontown, Pa 15401

If you have any questions call Pat Carter at 724-437-7439

 

 

 

 

 

 

Copy and paste the form below into a word document and mail to the address given or contact Pat Carter