Monroe County Green Party
Membership Form

Print this form, complete it, and mail it to:

Monroe County Green Party
P.O. Box 24
Bloomington, IN 47402-0024

Membership dues are $20 per calendar year ($10 after June 30).

Name  
Address  
 
 
Phone  
Email  

I am in general agreement with the Ten Key Values of the Monroe County Green Party:

1.   Ecological Wisdom
2.   Social Justice
3.   Grassroots Democracy
4.   Nonviolence
5.   Decentralization
6.   Community-based Economics
7.   Postpatriarchal Values (Feminism)
8.   Respect for Diversity
9.   Personal and Global Responsibility
10. Future Focus

Signature  
Date  
Dues Enclosed $