Join Us Online!

Step 1 - Give us your Info

Yes, I would like to join the POTRERO HILL DEMOCRATIC CLUB for calendar year 2010.
Regular Dues $25, Affiliate Member $20, Student/Low Income $15.

Payment online with PayPal.

I am a registered Democrat (or will be by the next election) and...

I am a resident of the Potrero Hill Area (the Club boundaries are Potrero Ave to the Bay, Cesar Chavez to King/Division)
   or
I am not a resident of the Potrero Hill Area - or I am not eligible to vote - but wish to support the Club as an Affiliate Member.

First Name:   * required
Last Name:   *
Email Address:   *
Address 1:   *
Address 2: 
City:   *
State:   *
Zip or Postal Code:   *
Phone:   *
Phone (eve): 
I would like to help with:  political action (voter registration,
      distribute election endorsement
      information)
membership development (meeting
      programs, new member contact,
      renewals)
fundraising to support Club activities
      (fundraising events to be determined)
tech support/maintaining web site
other - please specify
      

  
How did you hear about us?: 
Enter both security words:  *