WOMENS’ CAUCUS FOR POLITICAL SCIENCE MEMBERSHIP AND DUES FORM

Womens’ Caucus for Political Science -Western

(WCPS-W)

Membership and Dues Form

Name: _______________________________________________________________________

Mailing Address: ____________________________________________________________

City State Zip ________________________________________________________________

Email: _____________________________ Home phone:____________________________

Office Phone: _______________________________Fax: _____________________________

Date: ________________________ New Member ____ Renewal ____

Home Page URL: ____________________________________________________________

Annual wcps-W dues $10.00

gRADUATE sTUDENT mEMBERSHIP fREE

Designated Donations:

SPONSOR: Grad Student Memberships ($10 each) $ _______

Supplemental Contribution $ _______

You also have the option of joining and paying your NATIONAL WOMEN’S CAUCUS DUES:

(These dues will be forwarded to the Treasurer of the APSA Women’s Caucus)

Student/Unemployed/Retired Free ________

Salary under $15,000 $10.00 ________

Salary $15 - 40,000 $20.00 ________

Salary over $40,000 $30.00 ________

TOTAL: $_____________

Please make checks payable to WCPS-Western and mail to:

Melody Rose/Treasurer WCPS-W

Assistant Professor

Hatfield School of Government

Division of Political Science

P.O. Box 751

Portland State University

Portland, OR 97207

503.725.3137 office

503.725.8444 fax

e-mail: rosem@pdx.edu

Women's Caucus Link

THANKS FOR YOUR CONTINUED SUPPORT AND PARTICIPATION IN WCPS-W