Membership form

 Join the Democratic Club of Santa Maria Valley

Note:  Convenient membership and credit card payment also available                                                                             on our website with ActBlue.

Membership Application

Date____________________________________

Name___________________________________

Address_________________________________

City_____________________________________

State__________________ Zip Code__________

Telephone________________________________

Cell Phone_____________________________

Email____________________________________

 

Annual Membership Dues:

Individual/$20__ Couple/Family/$30__ Senior or Student/$10__

 

Sustaining Memberships:

Millennium * $1000 /person __      Half-Millennium  * $500 /person __

21st Century Club Member  * $210/person __

( *  In full or paid in 12 monthly payments with ActBlue.)

Century Club Member $100/person __   Half-Century  $50/person _

 

*Additional Donations to fund Club’s activities

$10__ $25__ $50__ $75__ $100__ Other  $___ Amount Enclosed ___________

Paid _____ Cash ____ Check ____No.____

 

Mail application and dues to:

 DCSMV

327 East Plaza Drive, Suite 2

Santa Maria, CA  93454

 

805-349-2708  Email:  dcsmv@dcsmv.net

Democratic Club of Santa Maria Valley PAC

CA  FPPC ID #1288725

Federal (FEC) ID COO447201

*Political donations are not tax deductible.