CLALLAM COUNTY DEMOCRATS
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The America We Believe In
Clallam Democrats Membership Form
If you prefer to complete a paper form, access one here:
PDF Form
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Date
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Precinct (if known)
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Name
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First
Last
Please fill out a CCD Membership Form for each member whether you are a new or renewing member...
Thank you!
Street Address
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Mailing Address (if different)
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City
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Zip Code
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Telephone No. (landline or cell -- your preference)
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Email
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You will receive announcements of events, activities, and other important information for members unless you instruct us otherwise.
Annual Membership Dues
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Member - $25 / Per Person
Two Householders - $40 (If you choose this option, please fill out a form for each member.)
Youth (under 25) - $5 Per Person
Supporting Member - $50 / Per Person
Century Club Member - $100 / Per Person
Other $
I would like to make a MONTHLY pledge to support the CCD General Fund, including operating expenses and support of endorsed candidates.
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$10
$15
$20
$30
$50
Other
Please help me set up an automatic withdrawal payment:
Occupation or Retired *
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(Required by the WA Public Disclosure Commssion)
Employer (if not retired) *
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Employer Address (if applicable) *
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This information is required by the Washington State Public Disclosure Commission on contributions over $100 in an election cycle.
Yes, I can help the Clallam County Democrats...
Choose Any
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Help staff the CCD office
Help with Events/Fundraising
Help with computer-based functions, e.g. data entry/retrieval
Help my local Precinct Committee Officer (PCO)
Help "Get out the Vote"
Make phone calls in support of Democratic candidates and/or endorsed policy positions
Identify potential yard sign locations
Write letters to the editor
March with Democrats in one or more summer parades
Help staff the CCD booth at the Clallam County Fair
If you have an interest in running for election, serving on the CCD Board, or becoming a Precinct Committee Officer, we can help! Email us at ccd@clallamdemocrats.org
I have special skills you may need:
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Dues and/or donations may be payable
online
or by
check
.
Online dues
can by made by clicking the
ActBlue logo
below.
If paying by
check
,
please make your check payable to:
Clallam Democrats
Box 2454
Port Angeles, Washington 98362
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