Join the Inland Mendocino Democratic Club Join Us Application Form for Membership through 8/31/21. Fields marked with * are required First Name * Name as registered to vote Last Name * Email * Nickname Physical Address where you are registered to vote - no PO Boxes Street * City * State * Zip * Phone Entering your phone means you agree to receive informational message via instant messaging. Mailing Address Street, City, State, Zip if different from registered address Are you currently employed? Yes No Campaign finance law requires us to collect your occupation and employer. Occupation or Retired * Employer * Campaign finance law requires us to collect your occupation and employer. Are you currently employed? Text Message Opt Out Do not send me text messages We send text information messages to alert you of important events and dates. Email Opt Out Do not e-mail me We send email to inform you of interesting and important events. Phone Message Opt Out Do not call me We call our active members to to inform you of events, actions, meetings and volunteer opportunities. reCAPTCHA Yearly dues through August 31: $30 Single, $45 Family. Please pay with ActBlue. Submit If you are human, leave this field blank.