Jefferson County Green Party Jefferson County Green Party
PO Box 1547
Port Townsend, WA 98368
Steve Hamm, Secretary
E-mail: steveh@olympus.net
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    • MEMBERSHIP & VOLUNTEER FORM

    Tell us about yourself and how the Jefferson County Green Party can contact you. Simply print out the following form and mail it to us.

    Name

    Organization

    Street Address

    City

    State/Province

    Zip/Postal Code

    Country

    Home Phone

    E-mail

    Do you have any specific interests, skills, comments or questions? Let us know:


    Check all that apply:

    Please contact me about Volunteering:
    Government/Elections Community Outreach Fundraising

    I would like to become an Active Member of the Jefferson County Green Party.
    I have read the Ten Key Values and am in general agreement with them.
    I understand my Annual Membership Dues are $20*.
    I would also like to contribute a Donation of: $5 $10 $25 $50 $100

    Please mail form and check to:
    Jefferson County Green Party
    P.O. Box 1547
    Port Townsend, WA 98368

    * Dues include $15.00 for the Jefferson County Green Party local chapter and an additional $5.00 for dues to the Green Party of Washington State. Fee waivers are available upon request, no questions asked.