Sign up to join the Middlesex United Way Women's Initiative! Dues are $35 and can be paid online or by check. First name: Last name: Name to appear on Badge (if different than above) Email: Home address: Phone number: Employer: Occupation/Job title: Birthday (Date): - None -01020304050607080910111213141516171819202122232425262728293031 Birthday (Month): - None -010203040506070809101112 Please check all that apply: I would like to attend monthly meetings. I would like to serve on the Fund Distribution subcommittee. I would like to serve on the Special Events subcommittee. I would like to serve on the New Membership Recruitment subcommittee. I cannot attend meetings but I would like to be informed of events and volunteer opportunities. Please select one: * Yes, I would like my name included in the WI Directory. I understand this will not be published on any website, social media or public electronic forum and will only be available to members as print versions for personal/business networking purposes. No, I would not like my name included in the WI Directory. CAPTCHAThis question is for testing whether you are a human visitor and to prevent automated spam submissions.