Benjamin Franklin Reform Democratic Club 2022 Membership Form
bfrdc.org (718) 796-6177
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Is it possible you are registered with a different name? Identify below, if applicable.
Address *
City
State *
Zip Code *
Cell
I (we) hereby certify that I am (we are) enrolled in the Democratic Party and subscribe to the purposes of the Benjamin Franklin Reform Democratic Club.  
-To provide an open, honest, dynamic, liberal, independent Democratic organization in the Assembly District.
-To promote the basic principles of the Democratic Party.
-To encourage the enrollment and participation in the Democratic party of all persons who subscribe to its principles.
-To seek and support candidates for public and party office of liberal conviction, ability, and integrity, who are dedicated to public service, progressive policies, and civil liberties; to encourage the appointment of qualified public officials and employee;, and to oppose patrongage abuses.
-To participate actively in the civic affairs of the community, and to futher the general welfare of all those who live and work in the community.
Signed (type your full name) *
Renewal or New Membership?
Clear selection
Type of Membership *
How will you be paying for membership *
How did you hear about us?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy