PFP Membership Form

1

Name* This field is required.

First Name

Last Name

2

Gender* This field is required.

Male

Female

3

Email* This field is required.

example@example.com

4

Phone Number* This field is required.

Area Code

Phone Number

5

Address* This field is required.Please provide your street address and district / neighborhood. (ex: 1 Street, District)

Street Address

Country

6

Which committee are you interest in* This field is required.Select the committee that you're most interested in.

Campaign Committee

Analysis Committee

Science Committee

7

Maybe you want to help with.* This field is required.

Canvasing

Distribution of Material

Administration Tasks

Social Media Management

9

I, the undersigned, agree:

To uphold the Party For Progress’ Constitution and By-laws for as long as my membership is active.
To the annual membership fee of $25 per year, to be rendered upon acceptance of my application.
To receive correspondence from the Party For Progress via digital media and print.

10

Please verify that you are human* This field is required.