*Yearly Dues: $40.00 Application Fee $10.00
*Dues include club pin, newsletter subscription and member directory.

                                         
                                     Membership Application

Name: ______________________________________________________________________

Address: ____________________________________________________________________

Telephone: ____________________________   Email:   ______________________________

Birthday: ______________________________   Best Time to Contact: ___________________

Spouse's Name: _________________________  Sponsored By: _________________________

Previous Member of WCAC? __________________

Please List Membership in other organizations (and offices held if applicable)
____________________________________________________________________________
____________________________________________________________________________


Special Interests (Please check all that apply):

____Arts & Crafts                  ____Literature                    ____Public Affairs        ____Scholarships

____Community Service        ____Crime Prevention        ____Legislation

____Music/Dance                  ____Status of Women        ____Library/Literacy

Others (Please List)_____________________________________________________________


*Please print, compete, and mail form with check payable to WCAC to:

WCAC
P.O. Box 606
Artesia, CA 90702

*to print: go to File drop down menu then Print