MEMBERSHIP & VOLUNTEER FORM

Tell us about yourself and how the Green Party of Kitsap County can contact you. Simply print out the following form and mail it to us.

Name

Organization

Street Address

City

State/Province

Zip/Postal Code

Country

Home Phone

E-mail

 

Do you have any specific interests, skills, comments or questions? Let us know:


Check all that apply:

Please contact me about Volunteering:
Government/Elections Community Outreach Fundraising

I would like to become an Active Member of the Green Party of Kitsap County.
I have read the Ten Key Values and am in general agreement with them.
I understand my Annual Membership Dues are $15.00*.
I would also like to contribute a Donation of: $5 $10 $25 $50 $100 Other

e-mail
 I would like to be added to the Party’s e-mail discussion groups.
 I would like to receive basic information only by e-mail

Please mail form and check to:

Green Party of Kitsap County
513 Madrona Way NE
Bainbridge Island, WA 98110

* Dues include $15.00 for the local chapter of the Green Party of Kitsap County and an additional $5.00 for dues to the Green Party of Washington State. Fee waivers are available upon request, no questions asked.