membership form

Membership Information

Current Membership Status *

• New Member
• Existing Member
• Honorary Member [Non-Mecklenburg County Resident]
• Life Member

Contact Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

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Zip Code

Employer Name *

Occupation *

Contact Number *

Email *

Political Information

City Council DistrictSelect From Options Below123456Other

County Commission DistrictSelect From Options Below123456Other

School Board DistrictSelect From Options Below123456Other

Committee Selection:

• Membership
• Budget/Finance
• Education
• Publicity
• GOTV
• Legislative
• Banquet
• Issues/Candidates
• Courtesy
• Community Affairs
• Economic Development

Signature *

Clear Signature

Membership Levels (Please Select One)

Membership Levels *

• General Membership ($30.00 + $3.00 service fee) - $33.00
• Honorary Member ($30.00 + $3.00 service fee) [Non-Mecklenburg County Resident] - $33.00
• Lifetime Membership ($500.00 + $25.00 service fee) - $525.00

Total Amount

$0.00

Submit