Baltimore City Green Party New Member Form
Members of the Baltimore City Green Party (BGP) make self-determined monthly contributions, vote on Party decisions and give direction to the Party. BGP Members must be registered to vote in Baltimore City, with "Green" as their party affiliation. Members must also set their own dues, based on their means.
Please use your name as it appears on government records. We need your date of birth to verify your voter registration. We are legally required to record your occupation and employer so that we can collect member dues. (The United States, Maryland and Baltimore Green Parties do not accept money from corporations or political action committees!)
The information you enter will not be shared outside of the United States Green Party and its electoral campaigns.
Apt or Unit Number
City, State (must be Baltimore, Maryland)
Date of Birth (voter registration verification)
Occupation (dues reporting)
Employer (dues reporting)
Do you subscribe to the 10 Key Values of the Green Party and wish to become a Member of the Baltimore City Green Party? 1. Grassroots democracy 2. Social justice and equal opportunity 3. Ecological wisdom 4. Non-violence 5. Decentralization 6. Community-based economics 7. Feminism and gender equity 8. Respect for diversity 9. Personal and global responsibility 10. Future focus and sustainability (
Are you registered to vote in Baltimore City as a Green? Update your registration at
Yes, I am registered to vote in the City of Baltimore and my party affiliation is "Green".
I'm not sure, but if not, notify me so I can update my registration.
As a requirement, BGP Members set our own monthly dues based upon our means. Please indicate your monthly commitment. A scale of suggested commitments, by annual income, is below. Dues can be paid monthly or annually. Pay dues online using the instructions at
or write your checks to "Baltimore City Green Party" and mail them to 100 E. 23rd Street Baltimore, MD 21218. (This form, including these instructions will be emailed to you.)
Income under $30,000 -- $5 Monthly
Income of $30,000 - $50,000 -- $10 Monthly
Income of $50,000 - $70,000 -- $15 Monthly
Income over $ $70,000 -- $20 Monthly
I will contribute another monthly amount. (Enter monthly amount below.)
Extreme Financial Hardship -- $1 Monthly
Enter another monthly amount (if applicable)
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service