Become a Friend
Beirut Madinati would like you to join its family of friends.  Please fill-in the form and short questionnaire provided.

Beirut Madinati is a political movement that seeks to build a political alternative outside sectarian frameworks, and aspires to reclaim and retain people’s social, economic, and political rights while preserving and fostering Lebanon’s cultural and natural heritage. Beirut Madinati takes transparency, public interest, social justice, and the continuous improvement in quality of life to be the basic principles of Lebanese politics.
Sign in to Google to save your progress. Learn more
Email *
Name *
Phone number *
E-mail *
Residential address (area & municipality) *
Electoral address (area & municipality) *
Age group
Clear selection
Are you now or have you previously been a member of any political group or party?
Clear selection
If Yes, which one(s)? Please specify the year you have joined and the year you have left.
Tick the box to be included
All information herein is in confidence is intended only for Beirut Madinati’s use and may not be disclosed to any third party or used for any other purpose but the one endorsed by Beirut Madinati.
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy