GPFL Active Membership Form Submission

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This form will be active from the start of the next Annual General Membership Meeting (AMM) until the AMM of the following year.

Email *

First Name (as it appears on voter i.d.) *

Last Name (as it appears on voter i.d.) *

Middle Name or Initial

Voter ID # OR Date of Birth *

Preferred name, if different from given name above

County *

Residential Address (address, apt #, city, zip) *

Telephone number

Registered Green?

Signer is a registered Green voter in the Florida county named above

Signer is not a registered voter in Florida, but meets criteria listed below

Clear selection

Not Registered Green? (Check all which apply)

Signer is under the legal voting age in Florida, but is at least 14 years old and resides in the Florida county noted above

Signer is a foreign national residing in the Florida County noted above

Signer has been legally disenfranchised (denied the right to vote) and resides in the Florida County noted above

In addition to above checked option/s, Signer affirms general agreement with the Ten Key Green Values, and with the principles embodied in the state and national Green Party platforms

Are you currently in contact with a local Green affiliate?

Yes, I affirm my active membership in the GPFL affiliate in my area, and I consent to be represented in the votes cast by this organization's elected delegates to the GPFL Coordinating Council..

No, I am not in contact with my local Green Party affiliate.

Other:

Please note:

All registered Green Party of Florida voters are eligible to vote in person at local or state party meetings and conventions. Active membership in the GPFL can be affirmed by filling out and submitting this digital form to GPFL. Any Florida resident ineligible to vote due to: being a minor, (but 14 or older), a non-citizen, or having lost the right to vote, may also affirm membership in the GPFL by the same procedure. Contact the GPFL at info@GPFL.org or call ‪813-291-2345‬ to volunteer with the state party or get information about a GPFL affiliate in your area.

Digital signature *

I affirm that the information given on this form is true and correct:

Required

Inspired to join a team, follow your interests, apply or expand your skills? Fill out the volunteer survey here.

https://www.gp.org/volunteer (this is on gp.org, national's site, and is shared with us)

Send me a copy of my responses.

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