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Hardin Co Young Democrats
Membership Application for Hardin County Young Democrats Chapter - Hardin Co. Kentucky
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First and Last Name
*
Your answer
What is your age?
*
This helps us understand the diversity and demographic information for our membership!
Younger than 15
15-20
21-30
31-40
I'd Rather Not Say
What are your pronouns?
*
How do you identify?
She/Her
He/Him
They/Them
Other:
What would you like to see our chapter do?
*
Let us know what you would like this chapter to do in our community.
Your answer
What is the best way to contact you?
*
After selecting, please place either your number and/or email in the boxes below!!
Email
Phone
Other:
Required
Email address
*
If you prefer phone number, please put “NA” in this box, unless you'd like to share both!
Your answer
Phone number
*
If you prefer email, please put “NA” in this box, unless you'd like to share both!
Your answer
Would you be interested in volunteer service?
*
Would you like to be placed on a volunteer list to help us get Democrats elected in Hardin County and Kentucky?
Yes
No
Maybe
Other:
If yes, what type of volunteer service would you like to do?
Your answer
By selecting the “I agree” box below, you understand that in order to become an active (Voting) member of the Hardin County Young Dems Chapter, you must pay your membership dues of $20.00 to our Treasurer.
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I agree
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