APPLICATION FOR MEMBERSHIP

Name/Title: ______________________________________________________________

Company:
________________________________________________________________

Street Address
____________________________________________________________

City_______________________________ State______________
Zip________________

Country
__________________________________________________________________

Email____________________________________________________________________
_

Email
(secondary)__________________________________________________________

Phone #’s: Office_______________

Mobile____________________________________

Birthday (Month/Date)
____________________________________________________

Other Affiliations/Special
Interests___________________________________________

HOME (optional)

Street Address
_____________________________________________________________

City ______________________State ____Zip

_________Country___________________

I prefer to receive mail at: My Business ____ My Home_______

ARE YOU LOOKING TO GROW YOUR BUSINESS? IF SO, HOW CAN

WE HELP YOU, i.e., opportunities, people you would like to meet,
potential panelist
__________________________________________________________________________
__________________________________________________________________________

HOW DID YOU HEAR ABOUT WOMEN OF THE WORLD?

__________________________________________________________________________
__________________________________________________________________________

WHAT DO YOU BELIEVE WE CAN DO COLLECTIVELY TO PREVENT

VIOLENCE AGAINST WOMEN? WHAT GROUPS CAN YOU
RECOMMEND THAT ARE INVOLVED IN THIS MISSION

__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

PAY ONLINE HERE:

CHARTER MEMBERSHIP – $195 yearly for the first 100 charter

members, delete

Type of Membership Selected: Annual $195 Gen Y (30 and

under) $100

Method of Payment: Check _____ (At address below)

Are you interested in joining our active WOTW members only group on
LinkedIn? Yes _____ No ____

Women of the World –

 111 E Chestnut St, #56A,
Chicago, IL 60611
312.467.0606
www.womenwotw.org
donna@womenwotw.org

Women of the World is a global organization committed to

developing strategic relationships that foster economic
opportunities, encourage thought leadership and elevate
awareness about the issue of violence against women.

Women of the World is a 501(C)(3) non-profit organization

based on purpose and passion, championing the truth that
safe, healthy, educated women influence prosperity.