Membership Roster Change Request LWGA Membership Roster Change Request Form Changes to the information in the LWGA Membership Roster/ Membership Book can be made by completing this form. The information will be sent to the current Membership Chair. Please use the Tab key to move from field to field. Name as Listed in the Current Roster* First Last Name Change First Last New Email Address Enter Email Confirm Email New Phone #New Mailing AddressNew Landings Location (i.e OR,MW,PL,DC,MSH)Other Changes or RequestsPlease Verify that the information you have entered is correct before clicking on SUBMIT. Thank You !In order to verify that you are a human being, you must check the 'I am not a robot' box below. Please follow any instuctions that follow. Without this verification, your request will not go through.CaptchaPhoneThis field is for validation purposes and should be left unchanged.