Sign up to join the Middlesex United Way Women United! Annual Dues are $50 and can be paid online or by check. Please fill out the form below. Information will be used for the Women United directory. First name: Last name: Name to appear on Badge (if different than above) Email: Address: City, State Zip Phone number: Employer: Occupation/Job title: Birthday (Date): - Select -01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Birthday (Month): - Select -01 02 03 04 05 06 07 08 09 10 11 12 Please check all that apply: - None -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. Please select one: - Select - 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 I understand this will not be published on any website, social media or public electronic forum and will only be available to members as print versions for personal/business networking purposes.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. Are you a new member? - Select - Yes No
