Libertarian Party of West Michigan

Subtitle

Print, fill out completely and mail to the address below.            Thank you!

It's easy to join the Libertarian Party of

West Michigan!

To become a member of the West Michigan affiliate, all we ask is that you sign the pledge and donate at least one dollar (but we will gladly accept larger amounts).

"I do not believe in or advocate the initiation of force as a means for achieving political or social goals."

(Please Sign)  ____________________________________________________________

 Name: ____________________________________________________

Address: ___________________________________________________

City, Zip: __________________________________________________

Phone #: ___________________________________________________

Email: _____________________________________________________

Occupation (Necessary for federal campaign rules): ___________________________

Contribution amount: $______________

Make checks or money orders payable to:

Libertarian Party of West Michigan or the LPWM.

Please mail to:

The Libertarian Party of West Michigan

PO Box 3685

Grand Rapids, MI 49501

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