Lifetime Membership – Individual | Michigan Indian American Democratic Caucus

Price:

$250

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Occupation: Occupation is not valid

Spouse Name (First and Last Name): Spouse Name (First and Last Name) is not valid

I would like to volunteer on these committees : I would like to volunteer on these committees is not valid

Membership Campaign Fundraising Events Educational Workshops Student Internships

Other ways I can help (Please describe):: Other ways I can help (Please describe): is not valid

Please select the citizenship status: Please select the citizenship status is not valid

US Citizen Green Card (Permanent Resident)

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Description	Amount
Lifetime Membership - Individual – Payment	$250.00
Total	$250.00

Payment

Pay via your PayPal account

No val Please fix the errors above