Home About Events Projects Support Contact
   
Member Information:
Female
Male
   
First Name
Last Name
Address (same as your voter registration)
City
State
Zip
Home Phone
Cell Phone
Email
Occupation
   
If you would like to get actively involved with BAIAD, please mark the appropriate area(s) of your interest:
   
Finance / Accounting
Interested in becoming a BAIAD officer
Website
Research
Writing
Membership Affairs
Public Relations / Media
Event Organizing
Fundraising
Legislative / Campaign Support
   
Type of Membership Requested:
   
Regular: $40
Student (with valid student ID): $10
Immediate Family (spouse, parent, child): $25
Associate (Non-Citizen or under 18): $25
Senior Citizen (65 and above): $25
Sponsors Circle: $200
Leadership Circle: $500
President's Circle: $1000
   
Additional donation:
   
$100
$250
$500
$1000
Other


If requesting "Immediate Family" type of membership, please provide the name of the "Regular" member in your family:
   
First Name
Last Name
   
Are you under 18 years old?  
Yes
No
   
Are you a US citizen?  
Yes
No
   
For US citizens only:
I am a registered Democrat (or I am registering to vote as a Democrat within the next 30 days)
 

 

Copyright © 2006 BAIAD. All Rights Reserved.

BAIAD has been chartered (officially recognized) by
the Santa Clara County and Alameda County Democratic Central Committees.