Membership Application And
Renewal Form

Women's Mining Coalition

Preferred Email Address:
Form for Printing Cell Phone:
Home Address: City:

Zip Code: - Zip+4


Work Address: City:

Zip Code: - Zip+4

Office Phone:


? Find your Congressional District
In which sector of the mining industry do you work?

Are you interested in participating in the WMC Annual Fly-In to Washington, D.C.?

May we publish your contact info in our online members-only directory? Your information will be available only to WMC members for networking opportunities.

In addition to my $30.00 dues payment, I would like to add an additional donation of
(suggested donation $20.00).

Copyright © 2015 Women's Mining Coalition