University of Washington Faculty Auxiliary                    Membership Registration

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NAME  ______________________________________________________________        STREET ADDRESS  ___________________________________________________ CITY  ________________________ZIP CODE________ PHONE_______________ E-MAIL ADDRESS (Print VERY clearly, please)  ___________________________ YOUR DEPARTMENT IF YOU ARE FACULTY  ___________________________ PARTNER'S NAME  ____________________HIS/HER DEPT.________________ MEMBERSHIP CATEGORY            REGULAR MEMBER  __________  (Faculty/staff or partner thereof)            FRIEND   ______________________  (All others)             Are you a first-time member? ______  Renewal?  ______   Rejoin? _______ Dues are applied to the operating expenses of the organization, as well as to other appropriate purposes as specifically defined in the UWFA Bylaws.  Dues are for the fiscal year beginning June 1.  Prompt payment of dues will ensure inclusion in the current  Directory published each October.      $20 SINGLE MEMBERSHIP                                    $___________________      $30 COUPLES (JOINT) MEMBERSHIP                 $___________________ SCHOLARSHIP DONATIONS:  We have provided full scholarships to UW undergraduate students for nearly 50 years.  Your contribution will help to continue this valuable service.      SCHOLARSHIP DONATION                                    $__________________        TOTAL ENCLOSED (DUES PLUS DONATION)    $__________________ Please make your check payable to and mail with form to UW Faculty Auxiliary, The University of Washington, Box 351380, Seattle WA  98195            Return to Membership Page