I would like to join WIZO as a New member/Renew my membership  

First name: ________________   Last name: __________________________

Address:  ______________________________________________________    Zip code: ___________

Tel (Home): ________________  Cell:_________________ Email:______________________________ 

Membership categories:  __ Annual ($36) __ Life ($200) __Gold ($500) __ Diamond ($1000)

__   I would you like to join the SF/Bay Area WIZO Nativ committee

__   I would you like to take an active role in organizing yearly events

Please print this page and mail it with your check to:

WIZO, 743 Stendhal Lane, Cupertino, CA

Please make check payable to WIZO

Please print this page and send it to us with your check.