National Women's Political Caucus of Florida

National Woman's Political Caucus of Florida Membership Application

NWPC/FL

Membership Application

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Time for a Change...

The National Women's Political Caucus of Florida is part of the only natural grass roots organization dedicated to increasing the number of women in elected and appointed office. We are a multi-partisan, multi-cultural organization dedicated to the election and appointment of progressive women in our state. 

We help progressive women at every level, regardless of party affiliation. We are a branch of the National Women's Political Caucus which has hundreds of state and local chapters across the country, all working to put women into the political pipeline and push them to positions of POWER!

If you would like to join The National Women's Political Caucus of Florida, please complete and submit this application and join  the women of Florida in our pursuit of the eradication of sexism, anti-semitism, racism, ageism, violence, poverty, discrimination against the disabled, discrimination on the basis of religion and and to ensuring reproductive freedom and freedom of sexual orientation.

First Name:
Last Name:
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City:
Zip Code: (5 digits)
State:
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Please Check One:
NEW MEMBERSHIP       RENEWAL

 Party Affiliation
 (optional)
Independent  Democrat   Republican
 I am interested in working specifically to further diversity by outreach to the following communities: BlackHispanicHaitian-AmericanAsian-PacificNative-AmericanYoung WomenOlder WomenSexual OrientationLaborDisability
 Membership Type
(please select one)
Yes! I want to increase women's political power and become a member of the National Women's Political Caucus. I am sending $60 for annual dues, which includes membership in the national, state and local caucuses.

$30 LIMITED INCOME MEMBERSHIP includes all voting rights and privileges of membership. Offered only to students and people with limited incomes.

I WANT TO DO MORE! I am submitting an additional contribution through my PayPal account *(include amount below)

I WANT TO DO MORE! I am submitting this form & mailing an additional contribution *(include amount below)
*Amount Submitted: $


For payments NOT sent by Paypal, please complete this form and submit.

Then send dues and donations by mail to:


NWPC/FL, 1861 Lyons Road #202, Coconut Creek, Fl 33063


(Premium Membership)
(Limited Membership)