University of Delaware Women's Club Membership Application/Renewal Form 2012/13
Name:		E-mail Address:
Street:
City/State/Zip Code:
Telephone:Home:		Work/Cell:
Dues($15.00)	Scholarship Fund Donation:		Please indicate if you are a new member to UDWC
UD Connection/Department   (  [   ] Self   [   ] Spouse)
Are you interested in volunteering for any of the following:
Scholarship Fundraiser___	Women of the Year___	Newsletter___	Other___

Make check payable to UDWC.  
Mail form and check to Flo Waibel,  41 The Horseshoe, Newark, DE 19711.

• University of Delaware   •   Newark, DE 19716   •   USA   •   Phone: (302) 831-2792   •   © 2008

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