18MR Member Registration Form

18MR Member Registration Form
Full Name*

First NameLast Name
Pronouns
City*
Phone Number*
E-mail*
example@example.com
Other Organization Affiliation
Ethnicity*
Gender
Birthday
Please describe you top 3 issues that you care deeply about *
Please describe your organizing experience*
What campaigns are you currently working on?
Why do you want to be an 18MR member? *
Which layer of membership are you committing to?*

General MemberActive MemberMember Leader (1 year commitment)
Which chapter are you interested in?*

NYCPhiladelphiaChicagoBay AreaVirtual
Which committee are you interested in?*

Political EducationCampaignMembershipUnsure
Would you like to join our discord server?*

YesNoI don't have discord, but I can create one!
What is your discord handle?*

0/10
Do you have any questions about 18MR or 18MR membership?
Should be Empty: