Together we can make a difference in our community!

Name: ___________________________________

Street: ___________________________________

City, CA, Zip: _____________________________

Home Phone: ______________________________

Fax: _____________________________________

Email Address: ____________________________

Signature: _______________________________
Member of the Democratic Party

Dues are:

$20 member

$10 for associate member*

*Associate members are:
º members under 18
Please state the year when you will turn 18 _______________
º residents not eligible to vote

Print this application. Send your completed and signed application to:

For more information call the membership director, Gene Calderón
510.614.9689 or treasurer Paul Frumkin 510. 510.785.0899.

Thank you!

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