Democratic Club Conejo Valley

Yes, I'm a Democrat and I'd like to support the Democratic Club of the Conejo Valley! Please use our secure ordering form to join, renew your membership or to make a donation, using your credit card or electronic check.

If you prefer to use snail mail, print and complete the following form (membership.doc), and mail with your check or money order made payable to:

DCCV
P.O. Box 4421
Thousand Oaks, CA 91359

PLEASE NOTE THAT MEMBERSHIPS ARE FOR THE CALENDAR YEAR.

Item

Membership Type/Donation

Amount*

Add item and indicate volunteer interest

Individual Membership - 2006

$20.00

Family Membership - 2006

$30.00

3. Senior Membership (65 and over) - 2006 $10.00

Volunteer Interest

4. Student Membership - 2006 $10.00

Volunteer Interest

5. Donation to DCCV $25.00

6. Donation to DCCV $50.00

7. Donation to DCCV $75.00

8. Donation to DCCV $100.00

9. Donation to DCCV You choose the amount!

To review your order, click here:

*Contributions are not tax deductible

Please submit the following information in the comments field when you complete checkout of your order, as it is required by federal law. If you are a student, unemployed or retired, you can enter “none” for both fields.

Occupation_________________________________________________

Employer___________________________________________________

By completing this order, you are certifying the following: You are a United States citizen or a permanent resident alien. This contribution is not made from the general treasury funds of a corporation, labor organization or national bank. This contribution is not made from the treasury of an entity or person who is a federal contractor. The funds you are donating are not being provided to you by another person or entity for the purpose of making this contribution.

5.	Donation to DCCV	$25.00
6.	Donation to DCCV	$50.00

7.	Donation to DCCV	$75.00
8.	Donation to DCCV	$100.00