Level of Membership:

Individual: $25.00

Senior (Over age 60): $20.00 

Veteran (US Armed Services): $15.00

Student: $10.00

Family: $40.00 (limited to 3 voting members, unlimited non-voting members)*

Please add $10 for each additional voting household member.
Number of additional voting family members: 1 2 3 4 5
 
Name(s):

Street Address:

City: State: Zip:

Home Phone:     Cell Phone:

E-Mail:    

Additional E-mail:

* Required by federal and/or state law. If you are not employed, please enter "none"

*Occupation of payee: * Employer of payee:


* I confirm that the following statements are true and accurate:

• I am a United States citizen or a permanent resident alien, and I am at least 18 years of age.
• This donation is from my personal funds, not from the general treasury funds of a corporation,
labor organization or national bank.
• I am not a Federal government contractor
• I understand political donations are not tax-deductible under federal law

I am interested in helping as a:

Please click submit to move to payment with a credit card.



* A family membership may include up to three active members.  Annual dues payable for family memberships will be increased by $10 for each additional member greater than three from the same household who also desires active membership status.

To pay by check, click here for a printable form that you can mail to us with enclosed payment.

If you require a waiver of dues because of financial hardship, please e-mail us at info@democratsofnapavalley.org