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2023 MEMBERSHIP FORM
New Member __________ Renewal __________
Membership Category(check one)
Individual ($25) __________
Family: two adults in the same household ($40) __________
Low Income ($15) __________ Low Income Family ($20) __________
Sponsor ($50) __________ Patron ($100) __________
Name _____________________________________________ Date __________________________
Address ____________________________________________________ Apt. # _______________
City _______________________________________ State ____________ ZIP _________________
Phone (Home) ________________________________ (Cell) ____________________________
Email _______________________________________________________________________________
Please pay your dues with a check, money order or via PayPal by following this link to the Three Parks website. Please make out all checks to Three Parks Independent Democrats.
Mail to: Three Parks Independent Democrats
Cathedral Station, P.O. Box 1316
New York, NY 10025
Attention: Treasurer
