Name:______________________________________________________________________________________
Address: ___________________________________________________________________________________
City, State, Zip:_______________________________________________________________________________
Phone Home:_________________________________ Work:__________________________________________
Email: ______________________________________________________________________________________
Institutional Affiliation: _________________________________________________________________________
Contributing Member $50. _______ Sustaining Member $100 _______ Student Member $25 _________
Please make checks payable to CWHC..
Send this application and check to: Chicago Women's History Center, 2109 N. Humboldt Blvd., Chicago, IL 60647
The Chicago Women's History Center is a non-profit educational organization with 501(c)(3) status. Your contribution
is deductible to the full extent of the law.
