Palos Verdes Peninsula Democratic Club
Membership Application Form
(Please Print)

Please send your membership form to:
P. O. Box 2234, Rolling Hills Estates, CA 90274

Name 1 ________________________________________________________
I am already a registered Democrat
Please send me a Voter Registration Form. (new Registration or Party change)

Name 2 ________________________________________________________
I am already a registered Democrat
Please send me a Voter Registration Form. (new Registration or Party change)

Address ________________________________________

City ________________________ Zip ______________

Phone (________)_____________________________

E-mail ______________________________________________

(__) Individual $20.00/year;
(__) Family (2) memberships $30.00/year;
(__) Young Adult $10.00/year

Amount Enclosed $ _______________________ Renewal New Member(s)

I might be interested in helping in the following areas:
Hospitality Newsletter Membership
Voter Registration Campaign Work Fund Raising
Refreshments Correspondence Phone Tree
I might offer my home for a meeting or social event
 Publicity
Other: ______________________________________

Invite a Friend or pass on this membership application!


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