Libertarian Party of Boulder County Membership Application

1. Membership Option:

   One year for $15
   
   Three years for $42

2. In addition, please accept my contribution of   $___________ to the LPBC.
   
   
3. TOTAL payment=  $___________
   
   
4. Please make check payable to: LPBC
   
   
5. Member information:
   
   

   Name:
   Address:
   City/State/Zip:
   Home Phone:		Work Phone:
   Email:

   
   
6. To become a voting member of the LPBC, you must sign the Libertarian Pledge. By not signing, you will become a non-voting member. Libertarian Pledge: I hereby certify I do not believe in, or advocate, the initiation of force as a means of achieving political or social goals.*
   
   

   Signature:

   Date:

   
   
7. Please return to:   LPBC   •   2525 Arapahoe Ave, Suite E4, PMB 427   •   Boulder, CO 80302

*Note: if you don't like the wording of pledge but still wish to be a voting member, you may prepare an alternate statement for Board approval.

For more information about the Libertarian Party of Boulder County, please visit our web site at www.lpboulder.org
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