Membership Application Form Join Solidarity 1804 and Support Our Mission for Justice and Development Name * First Name Last Name Date of Birth * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Membership Type * Individual Member - Annual Fee: $25 Organizational Member - Annual Fee: $100 If you selected organizational member, please enter the name: Areas of Interest * Please select all that apply Advocacy and Outreach Research and Documentation Finance and Fundraising Legal and Policy Event and Campaigns Volunteer Opportunities How did you hear about us? * Social Media Website Friend/Colleague Event Input Name to Agree with Statement Below * I, _________ (full name), hereby apply for membership in Solidarity 1804. I agree to support the mission and objectives of the organization and to adhere to its bylaws and code of conduct. Additional Comments or Questions Thank you!
