Benjamin Franklin Reform Democratic Club 2021 Membership Form
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Is it possible you are registered with a different name? Identify below, if applicable.
Renewal or New Membership?
Type of Membership
Standard ($35 per member)
Senior – 65+ ($25 per member)
Young Democrat – 26 or younger ($25 per member)
How will you be paying for your membership?
I (we) hereby certify that I am (we are) enrolled in the Democratic Party and subscribe to the purposes of the Benjamin Franklin Reform Democratic Club.
-To provide an open, honest, dynamic, liberal, independent Democratic organization in the Assembly District.
-To promote the basic principles of the Democratic Party.
-To encourage the enrollment and participation in the Democratic party of all persons who subscribe to its principles.
-To seek and support candidates for public and party office of liberal conviction, ability, and integrity, who are dedicated to public service, progressive policies, and civil liberties; to encourage the appointment of qualified public officials and employee;, and to opposepatrongage abuses.
-To participate actively in the civic affairs of the community, and to futher the general welfare of all those who live and work in the community.
Signed (type your full name)
How did you hear about us?
A copy of your responses will be emailed to the address you provided.
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