Application for Membership

Application for Membership

 

MEMBERSHIP LEVEL:

Descriptions for each membership level can be viewed here.

 Individual Family Young Dems (30-40) Young Dems (18-29) Non-Resident Business & Professional

APPLICANT NAME:

First Name (required)

Middle Initial

Last Name (required)

 Ms. Mrs. Mr. Dr.

Second Applicant: Family Membership

First Name

Middle Initial

Last Name

 Ms. Mrs. Mr. Dr.

CONTACT INFORMATION: (WNDC mail will be sent to home address unless otherwise requested.)

HOME

Street Address

Apt #

City

State

Zip Code

BUSINESS

Name of Business/Company

Street Address

Suite #

City

State

Zip Code

Home Phone

Business Phone

Cell Phone

Preferred Email (required)

EMERGENCY CONTACT (please list two)

Emergency Contact 1: Name

Emergency Contact 1: Phone

Emergency Contact 2: Name

Emergency Contact 2: Phone

BACKGROUND INFORMATION

A. Biographical Data

1. Date of Birth

2. Colleges/Universities Attended and Degrees Earned

3. Current Position (previous if retired)

4. Volunteer Activities (previous or current)

B. Interest in WNDC

1. How did you hear about the Club?

2. Member who referred you (if applicable)

3. Club activities that interest you (please mark each box that applies)
 Political issues, discussions Political action and campaigns Arts, music and other cultural events Personal use of Club facilities for meetings and social events Author presentations and book discussions Evening receptions/wine & food related events Films Game groups (bridge, Scrabble, chess) Networking with friends and associates

4. Event time preferences (please mark each box that applies)
 Morning/Breakfast Afternoon/Lunch Evening/Dinner

5. Committees I might like to join (please mark each box that applies)
 Administration/Building and Grounds Committee Communications Committee Educational Foundation (Whittemore House preservation, educational programs, community outreach) Membership Committee Program Planning Committee Public Policy and Political Action Committee (PPC) PPC Task Forces DC Statehood Education/Children’s Issues Earth and Environment Faith and Values Global Women Gun Policy Health Care Social and Economic Justice Voting Rights and Election Reform

To complete your membership application, please agree to the terms and conditions and click on the submit button below. By submitting your application, you agree to become a member for at least one year and to pay your dues, food and beverage minimums, and fees for events you attend.

You will receive an e-mail notification once we receive your application. The Board of Governors reviews and responds by mail to all applications within 30 days. Your credit card will not be charged (except for your one-time application fee) until your application has been accepted. At that time, you will receive a notice of acceptance and a link to the PayPal dues payment page for your membership level.

Terms and Conditions: By submitting this application, you agree to a one-year membership and to paying dues and all other required fees.
 I accept. I do not accept