Join the West Bloomfield Lakes Area Democractic Club

USE PAYPAL TO JOIN ONLINE
Membership rates


If not paying online please complete membership form and mail check to:

Muhommed Hussain
WB Dems Membership
PO Box 252913
West Bloomfield, MI 48325-2913
Make checks payable to: "West Bloomfield/Lakes Area Democratic Club"


Member 1 First Name ... Last Name ...
Member 2 First Name ... Last Name ...
Address Line 1 ... Address Line 2 ...
City ... State ...
ZIP Code ...
Email Address 1... Email Address 2...
Daytime Phone ... Evening Phone ...
School (if student)

Individual
$25
Couple
$35
College Student
$10
High School Student
$5

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