Membership & Renewal Application

As a member of the Heartland Women’s Network, you will have access to knowledge, resources, contacts, and support from other women in the Heartland.

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Personal Information:

Name *

First

Last

Phone/Mobile *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How did you hear about us?

Company Information:

Company of Employment:

Title:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Years of Service:

Currently Seeking Employment:

If you know someone who might be interested in membership, that you would like to refer to HWN, please enter their information below:

First Membership Referral

First

Last

Phone

Second Membership Referral

First

Last

Phone

Pay New Member Dues – $50.00*:

Local Dues – $45
Non-profit/Charity contribution – $5.00
TOTAL DUES – $50.00

Member Dues

Price: $ 50.00

*Membership is not complete until payment is received.

As a member of the Heartland Women’s Network, you will have access to knowledge, resources, contacts and support from other women in the Heartland.

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