Copy of MEMBERSHIP | Big Bear Dem Club

First Name

Last Name

Phone

Home Address

Home Address Line 2

City

Region/State/Province

Postal / Zip code

Mailing Address

Mailing Address Line 2

City

Region/State/Province

Postal / Zip code

MEMBERSHIP STATUS Required

NEW MEMBER

RETURNING MEMBER

YEARLY RENEWAL

I AM A REGISTERED DEMOCRAT - REQUIRED

OCCUPATIONAL STATUS - REQUIRED CAMPAIGN FINANCE LAW Required

RETIRED

UNEMPLOYED

EMPLOYED BY:

Company

Annual Club dues are $25.00 per person

If you would like to make a contribution to the Club Treasury there are now levels! (totally confidential)

$30.00 John Lewis

$40.00 Nancy Pelosi

$50.00 Barack Obama

$75.00 Kamala Harris

$100.00 Joe Biden

Make check payable to:

Democratic Club of Big Bear Valley (DCBBV)

Mail to: Democratic Club of Big Bear Valley

PO Box 6578

Big Bear Lake, CA 92315-6578

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