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Female
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First Name
Last Name
Address (same as your voter registration)
City
State
Zip
Home Phone
Cell Phone
Email
Occupation
   
   
Finance / Accounting
Interested in becoming a BAIAD officer
Website
Research
Writing
Membership Affairs
Public Relations / Media
Event Organizing
Fundraising
Legislative / Campaign Support
   
   
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
   
   
$100
$250
$500
$1000
Other
   
First Name
Last Name
   
Are you under 18 years old?  
Yes
No
   
Are you a US citizen?  
Yes
No
   
I am a registered Democrat (or I am registering to vote as a Democrat within the next 30 days)