NDTDW Membership/Renewal Application Portal
You can choose to pay on-line through the PayPal form below (no PayPal Account Needed) or you can print this form and mail it with your payment to: Lenna Webb, Treasurer, 17201 Hidden Glen Drive, Dallas, TX 75248. NOTE: By submitting this form, I certify I am a Democrat who supports the goals of NDTDW. I understand that NDTDW is a General Purpose Action Committee. (GPAC)
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
Home Number
-
Area Code
Phone Number
Cellular Number
-
Area Code
Phone Number
Occupation
*
Employer
*
Precinct Number
Congressional District
State Senate District
State House District
Spouse or Partner's Name
Birthday (month & Day) if 30 years or younger, include the year!
I would like to be a member and be notified of:
Book Club Meetings
Type of Membership
*
New
Renewal
I will pay by
*
Credit Card using the PayPal portal
I will mail my check payable to NDTDW to Lenna Webb, 17201 Hidden Glen Drive, Dallas, TX 75248. Please print this form and include with your check. Note, if you select this option, skip the membership selection below and click on Submit!
I am entitled to a FREE membership as I am 30 or younger.
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Ann Richards Membership
$45.00
$
45.00
Rosa Parks Membership
$75.00
$
75.00
Eleanor Roosevelt Membership
$125.00
$
125.00
Student Membership
$10.00
$
10.00
Leave Us a Tip to Cover Credit Card Fees
$5.00
$
5.00
FREE 30 and younger Membership
Free
$
Free
Total
$0.00
$
0.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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