Democrats United for Progress Membership Application

We, Democrats United for Progress, are dedicated to the spread of the ideals of freedom by offering hope to our community for a better life in Mendocino and Sonoma Counties and our nation, through leadership, education, creative ideas, progressive action and local and national activism.

Any registered Democrat or youth under 18 who supports the purposes of this organization is

eligible for membership upon payment of the prescribed annual dues.

Membership for current calendar year.

(New members who join in the last quarter of a year will have their dues cover the next year as well.)

Name : ___________________________________

Address: _____________________________________________________

City _______________________________ State/Zip _____________________

e-mail: ____________________________________________

(Telephone): ______________________________________________

(fax): _____________________________________________

Please return completed form with Dues payment of $10.00 or $15.00 for a family membership (two or more members living in the same household).

Make check payable to: Democrats United for Progress,

(Sorry, no credit cards accepted) send to:

Marty Hoover, Treasurer

Democrats United for Progress,

P.O. Box 805, Gualala,

CA 95445

Check here if you wish to join, but dues presents a hardship