Name (required)

Name(s) (for Pairs and Family memberships)

Address

City

ZIP

Phone

Email (required)

Occupation*

* Federal law requires us to use our best efforts to collect and report the name, mailing address, and occupation of individuals whose contributions exceed $200 in a calendar year.

I recommend contacting as a possible member:
Name

Phone

Email

Please check the dues structure that applies:
$10 - Senior, Student, Limited Income$25 - General Membership (1 member)$35 - Pairs (up to two members)$45 - Activist (up to 3 members)$75 - Family$120 - Supporting Membership$240 - Friend$600 - Patron

I would like to support the LCDP with an additional donation of
$

Total Amount Paid
$

Contributions are not tax deductible for federal income tax purposes. Your contribution may be used in connection with federal elections and is subject to the limitations and prohibitions of the Federal Election Campaign Act.

I'd like to join the following caucus(es) (check as many as apply:
American Indian caucusBlack caucusDisability caucusEnvironmental caucusLabor caucusLatinx caucusLGBT caucusProgressive caucusRural caucusVeterans' caucusWomen's caucus