GOLD PARTY

MEMBERSHIP APPLICATION FORM


NAME ________________________ __________________ ___________
                           last name                             first name           middle name                 

ADDRESS __________________________ _________________________
                            street address                                  city, state, zip code    


Email address ____________________          Telephone number _______________             

Dues paid (please circle)      1 cent      $10.00      $50.00      $200.00      $500.00     $1,000.00    $5,000      other ______

Membership renewal ?            yes ________            no __________

Designated sponsor (if any) ____________________________________

Political preference/ party affiliation __________________________________

 

Veteran? _______        Wounded veteran? _______

Comments _______________________________________________________

 

Membership in Gold Party does not preclude membership in another political party. It does not commit anyone to voting a certain way in elections. The point system used for voting in internal decisions rewards individuals for their contribution in building up the party. Welcome to Gold Party. Help the movement grow.

 

SIGNATURE _________________________________    DATE ________________

 

Send completed form plus membership dues to:

Gold Party

1702 Glenwood Avenue

Minneapolis, MN 55405

U.S.A.

 

mailto: 2wmcg@earthlink.net

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