DEMOCRATS OF NAPA VALLEY CLUB MEMBERSHIP APPLICATION

I live and am registered to vote in Napa County as a Democrat. Please sign me up as a
Voting Member of the Democrats of Napa Valley Club.

Level of Membership:
Individual: $35.00   Family: $50.00   Senior (65+): $20.00   Student: $10.00

  Membership: $ ________   
Would you like to make an additional donation to support our activities during this crucial election year? Donation: $ ________  
  Total enclosed: $ ________  

Your Information:

Name(s): ________________________________________________________________

Street Address: ___________________________________________________________

City ____________________________ State: CA    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 am interested in helping as a:
Donor of Goods  Donor of Services    Volunteer Committee Member

Areas of Interest:    Events   G.O.T.V.     Membership    Speaker's Program
Technical/Website   Fundraising   Executive Committee   Community Outreach/Education

Please send this form with your check payable to: Democrats of Napa Valley
P.O. Box 206
Napa, CA 94559
 


Please contact me for a confidential discussion about criteria for a waiver of dues because of financial hardship.

Any questions? E -mail us at: membership@democratsofnapavalley.org Back to Join Us Page