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FALLBROOK DEMOCRATIC CLUB MEMBERSHIP APPLICATION

PLEASE PRINT

Date: ____________

Name(s): ______________________________________________________

Address: ______________________________________________________

Phone Numbers:  H) _______________ (C) _______________

Email address: __________________________________________________

I am a registered Democrat: Yes (  )  No (  )
I am interested in volunteering for the Club ________    political action  event planning   Be a Club officer  other __________________

Annual Dues: Individual ($10) ________

Please make your check payable to: Fallbrook Democratic Club

Please print out this Membership Application and bring with check to our next meeting or mail to:

Fallbrook Democratic Club
P.O. Box 293
Fallbrook, CA. 92088

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