MEMBERSHIP APPLICATION

Welcome To The
PORTAGE COUNTY (WI) DEMOCRATIC PARTY

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“YOU ARE THE LIFE OF THE PARTY…!”

Help us increase our Portage County Democratic Party Membership.

Please use the membership form below.

PORTAGE COUNTY DEMOCRATIC PARTY AND DEMOCRATIC PARTY OF WISCONSIN

2008 MEMBERSHIP FORM

NAME(S)

Sign me up for:

$1200   Investor *(*includes all family members)

ADDRESS

$   600 Patron *

CITY

$    240 Friend *

STATE              WI

ZIP

$    120 Supporter *

PHONE

$      75 Family *

EMAIL

$      45 Activist (Includes up to 3 memberships)

$       35 Pair (Includes 2 memberships)

$       25 General

COUNTY PORTAGE

CONGRESSIONAL DISTRICT   7^TH

$       10 Limited Income

SELECT ONE:

RENEW MEMBERSHIP

NEW MEMBERSHIP

MAKE CHECKS PAYABLE TO: PCDP

And mail to:

PCDP

(Portage County Democratic Party)

PO BOX 515

STEVENS POINT WI 54481-0515

PLEASE PRINT AND MAIL WITH PAYMENT

Paid for by the Portage County Democratic Party, Gerald Ugland, Treasurer