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
Date *
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First Name *
Your answer
Last Name *
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?
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) *
Your answer
I am a registered voter in (Please indicate which County and State) *
Your answer
Voter Registration Number (Found on VR card) *
Your answer
Voter Precinct Number (Found on VR card) *
Your answer
Date of Birth *
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I am interested in becoming involved in the following committees (check all that are applicable): *
Required
Please indicate which committee is your first choice: *
Please indicate which committee is your second choice: *
Please indicate which committee is your third choice: *
Would you be willing to chair a committee? *
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.
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