Women Education Leaders in Virginia

        Membership Form
(read information at bottom of page) 

Check one: New Member Renewal

 Name:

 Position/Title:

School/Organization:

 School Division:

 Region: (click here for Region List)

Home/Preferred Mailing Address:

Business Phone Number:

Fax:

E-mail (required):

Payment Options (Due to the high cost of credit card fees we are not able to process a payment of $25 or less. Thank you for your understanding)

1. If you would like to use a purchase order, print out this form and fax it along with your purchase order to
    (540) 832-7666

2. Mail your registration form and a check, made payable to WELV to:
    WELV
    PO Box 169
    Gordonsville, VA 22942

If you are unsure of your membership status, please call Judy at (434) 882-2327.