Name and Address

 

Primary Phone Number

 

Secondary Phone Number

 

Email Address

 

Occupation

 

Congressional District

 

Category

Special Skills

 

 

Method of Payment

Pay By Check or Cash - Please print out the " Membership Form Printable" located in the "Membership Form" drop down menu. Send your form and payment to be made out to "YES WE CAN Democratic Club" and mail it to "YES WE CAN Democratic Club 682 Orizaba Ave., Long Beach CA 90814" or you can bring it to our next meeting on the first Thursday of the month.

 

Credit Card Payment - After submitting the form, click the "Contribute with ActBlue" button located on the right side on all pages of the website to submit your payment with a credit card.

Thank you! 

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