EmailMe Form - Membership Registration/Renewal Form

Name of Member *

First Middle Last

Phone *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

New Membership Registration Fee

Active Member - 2500 ($10.00)

Associate Member - (Contact Office)

Associate Members should contact the General Secretariate

Membership Annual Contribution

Active Member - 20.000 ($50.00)

Associate Member

Associate Members should contact the General Secretariate

Method Payment

Bank Deposit

Epay (Credit/Debit)

Cash (At Location)

Contact the Secretariate for details about the chosen payment method.

Membership Declaration *

I wish to become a member of United Socialist Democratic Party

I am eligible to enroll for National elections

I am not now a member of any other political Party and if I join anoher Party in future I shall inform USDP

I commit to comply with the Constitution, ByLaws, the Manifesto and policy principles

I acknowledge that banking of my fee does not make me a member until my application is formally approved, and that the Party may in its absolute discretion refuse my membership application and refund my fee

I declare that all the information I have given on this Form is true and complete.

Signature *

Confirm