WOMEN’S COUNCIL OF RIT
Membership Application
July 1, 2017 through June 30, 2018
Annual Dues:
Please make your check payable to:
Mail to:
$35.00
Women’s Council of RIT
Audry Liao
P.O. Box 307
Brockport, NY 14420
In addition to Council Notes and operating expenses, dues help support these projects:
Margaret’s House (child care facility)
Women’s Council Scholarship Funds
Bridge the Gap Fund
Outstanding Female Senior Student Award
RIT Ambulance Corps
- - - - - - - - - - - - - - - - - - - - Cut here and return with check - - - - - - - - - - - - - - - - - - - - - - - - - - -
Dr./Mrs./Ms./Miss First Name_____________
MI __ Last Name____________________________
(circle title)
Address_________________________________________________________________________
City, State, Zip ___________________________________________________________________
Phone Numbers Home______________ Mobile_______________ Work ____________________
E-mail Address ___________________________________________________________________
Name preferred on Name Tag __________________________
I will accept email meeting announcement
I would be interested in serving on the Board or a committee?
Yes
Yes
No
No
Annual Dues
Gift (Tax Deduction) - Indicate below your preference
$
35.00
Total Amount Enclosed
Please direct my gift to the ongoing programs of the Women’s Council of RIT
$ _____
Please use my gift where needed most to support the Women’s Council of RIT $ _____
Please direct my gift to the “Bridge the Gap Fund”
$ ______
If you wish to send a gift to the Endowed Scholarship,
please contact Heather Engel,
Assistant VP, Development & Alumni Relations, 585-475-2627
Do not write below this line
Date Received _________
Check Number_______
Recorded in Database_________