Membership Application
Thank you for your interest in the Democratic Women’s Club of Lakeland. We are very pleased that you want to become a member. We meet every fourth Monday of the month from 6:30pm to 8:00pm at 1515 Williamsburg Square in Lakeland. We have a social time before each meeting at 6:00pm where you can register for membership, update your voter registration, or just mingle with other members You can find out more about us at:
www.DWCLakeland.com
* Required
Date
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MM
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DD
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YYYY
First Name
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Your answer
Last Name
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Your answer
Email (Not required but recommended to receive important updates)
Your answer
If you provided an email address, would you like to receive email updates from the Democratic Women's Club?
yes
no
Clear selection
if you select 'yes' you will receive email updates via MailChimp from the club, you can opt out at any time.
Phone number
*
Your answer
Alternate phone number (optional)
Your answer
Address (Street, City, State, Zip)
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Your answer
I am a registered voter in (Please indicate which County and State)
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Your answer
Voter Registration Number (Found on VR card)
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Your answer
Voter Precinct Number (Found on VR card)
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Your answer
Date of Birth
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MM
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DD
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YYYY
I am interested in becoming involved in the following committees (check all that are applicable):
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Programs Committee
Membership Committee
Publicity Committee
Hospitality Committee
Telephone Committee
Ways and Means Committee
Financial Review Committee
Campaign 2020
Required
Please indicate which committee is your first choice:
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Choose
Programs
Membership
Publicity
Hospitality
Telephone
Ways & Means
Financial Review
Campaign 2020
Please indicate which committee is your second choice:
*
Choose
Programs
Membership
Publicity
Hospitality
Telephone
Ways & Means
Financial Review
Campaign 2020
Please indicate which committee is your third choice:
*
Choose
Programs
Membership
Publicity
Hospitality
Telephone
Ways & Means
Financial Review
Campaign 2020
Would you be willing to chair a committee?
*
Yes
No
The Board of Directors is up for election this November 2019, If you are interested in running for any of the offices please check all that apply.
Club President
First Vice President/Chair of the Programs Committee
2nd Vice President/Chair of Membership Committee
Treasurer/Chair of Ways and Means Committee
Recording Secretary
Corresponding Secretary
Legislative Liaison
Regional Council Representative
Parliamentarian
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