Valley Grassroots for Democracy Membership Application


Name:
Address:
City:
Zip:
Home Phone:
Work Phone:
Email address:
Languages spoken:
Occupation:
Employer:
Other organizations I'm in (political, social, union, etc):

I am a registered Democrat.
I am not a registered Democrat but intend to register as a Democrat as soon as I am eligible.

Only registered Democrats or those intending to register as Democrats as soon as eligible can join VGFD as dues-paying members. All others may join as associate members. Associate members do not pay dues and are ineligible to vote in club matters or hold leadership positions, however they may participate in all other club activities.
I would like to join VGFD as an associate member.

I would like to be active and volunteer my time and skills.
I would just like to be informed of activities where I can participate.
I can volunteer/participate hours per month.

My volunteer interests: (check all that apply)
Tabling Bylaws Truth in Recruiting
H.S./College Outreach Liaison to Elected Officials Endorsements
Senior Citizen Outreach House Party Host Speakers Bureau
GOTV Visibility/Protests/Marches Meeting Setup
Fundraising Community Service Graphic design
Special events Letter Writing Technology
Publicity/PR Writing/Editorial Hospitality
Other:

My political priorities: (check all that apply)
Social Security Health Care Civil Rights
War in Iraq Voter Protection Foreign Policy
Clean Money Environment Education
Economy Corporatism Corruption (Business/Govt)
Other:

Comments and Suggestions:


Dues are $15 per year, payable each January. You may submit your dues via mail or online via ActBlue. After you submit this form you will see further instructions. Those claiming a hardship are not required to pay dues.

VGFD is a Democratic Club chartered by the Los Angeles County Democratic Party. Contributions to VGFD are not deductible for federal income tax purposes.