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: Email: Home address: Phone number: Employer: Occupation/Job title: Birthday (Month): - None -010203040506070809101112 Birthday (Date): - None -01020304050607080910111213141516171819202122232425262728293031 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. I would like to be a guest speaker at a future networking breakfast or I know someone who would. Please note topic/speaker below. (Topic/speaker): CAPTCHAThis question is for testing whether you are a human visitor and to prevent automated spam submissions.