Membership Payment Form If you have any issues or questions about a membership category or a method of payment, please contact Suzanne King at firstname.lastname@example.org. This Payment is For (SELECT ONE) * Renewal New Application First Name Last Name Email Address Membership Status * ACTIVE New Member Dues $135.00 includes Name Badge ACTIVE Reinstated Member Dues $120.00 DUAL New Member Dues $112.00 includes Name Badge I am an Active member of Naples Junior Woman's Club and am in good standing. * Yes Approval pending review by Membership Chair. I agree, as a member, to serve on at least one committee. * Yes Approval pending review by Membership Chair. Please select ONE (minimum; TWO maximum) committee(s) for service during the upcoming year. Archives(no members needed currently) Artisan Marketplace Arts & Culture Circle of Support Civic Engagement & Community Outreach Clubhouse Grounds Communications Dining For Philanthropy Education (Scholarships Empowering Women's Scholarships Luncheon Environment Flea Market General Federal of Women's Clubs Liaison (GFWC) Health & Wellness Hope Committee (Formerly Domestic Violence) Hospitality Investment (Experience Required) Juniorettes Juniors (no members needed currently) Kitchen Tour & More Libraries Meeting Event & Decor Membership Passion for Fashion Tea Philanthropy(no members needed currently) Photography (Communications) Providence House Shop & Share Events Social Social Media (Communications) Sponsorships Sustainer Member: No Committee choice Treasury Website (Communications) Click here to see committee descriptions Address (credit card billing address) Address (credit card billing address) Address (credit card billing address) Address (credit card billing address) City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Credit Card Credit Card Credit Card Number (Visa or Mastercard) Credit Card Number (Visa or Mastercard) Credit Card Month 123456789101112 Exp Year Year 20242025202620272028202920302031203220332034 Exp Year CVV CVV Exp Month PAYMENT BY CHECK Please make check payable to Naples Woman's Club send to: Naples Woman's Club PO Box 662 Naples, FL 34106 Please indicate member name on the check If you are human, leave this field blank.