Membership form

EJDC MEMBERSHIP FORM

* Indicates required field

Name *

First

Last

Preferred Pronoun *

Email *

Street Address *

Line 1

Line 2

City

State

Zip Code

Country

Eligibility

I am not a member of another political committee
I am a current resident of the City of Essex Junction
I have read and agree with the posted by-laws and platform of the Essex Junction Democratic Committee
I am at least eighteen years old.

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I confirm that the above statements are true and accurate

PO Box 5481
Essex Junction, VT 05453

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Check the box if you are requesting a financial waiver for annual dues

Thank you for your interest in joining the Essex Junction Democratic Committee! We'll get back to you soon.