Suburban Maryland
Business and Professional Women
Membership Application

Membership is open to all individuals who support the mission and objectives of BPW/USA. Membership in Suburban Maryland BPW is $85.00 per year. Full-time students may join for $39.00 per year. Membership through the local organization of Suburban Maryland includes membership in the local, state, and national levels of BPW.

Print out this application and mail it with payment to: Suburban Maryland BPW, Aileen Worrell, 4709 Levada Terrace, Rockville, MD 20853

Please Print:

Name: ______________________________________________________________________ 



Organization: _______________________________________________________________



Address: ____________________________________________________________________



City: ______________________________  State: __________ Zip Code ____________



Work Phone: _________________________  Home Phone: __________________________



Fax: __________________________  E-mail Address ____________________________

Dues are based on membership option selected. Check one.

Professional $85.00

Full-time Student $39.00 (Attach copy of student I.D.)

All payments must be made in U.S. dollars only by check, cash or money order. Checks should be made out to Suburban Maryland Business & Professional Women.