Membership Form

As Democrats who care for the truth, the environment, science, choice, and other people regardless of race, ethnicity, sexual preference and legal status, it is important that we connect and make our voice heard. If you are not a member of the Club please consider completing the form below and sending it in. If you would like to be on our list-serve please provide your contact information so we can keep you informed on important upcoming issues and elections.

Please print this page

Complete the form

Name: _____________________________________

Address: _____________________________________

Email: _____________________________________

Phone: _____________________________________

and mail to

North Salem Democratic Club

Post Office Box 525

North Salem, New York 10560

Dues: $25 Family, $15 Individual, $10 Youth or Senior

Thank you.