Women's Action Coalition of Prince George's County

To join, please complete the following form and send it with a check for $25.00, payable to the Women's Action Coalition of Prince George's County, to:

Treasurer, WAC

Box 56

College Park, MD 20740

Organization Membership

Individual (Non-Voting) Membership

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Phone (W)

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Organization/Name
Address:
City	State	Zip Code
Phone (H)	Phone (W)
E-Mail

Organization Representative
Address:
City	State	Zip Code
Phone (H)	Phone (W)
E-Mail

Organization Alternate
Address:
City	State	Zip Code
Phone (H)	Phone (W)
E-Mail