WORLD CITIZENS PARTY for a DEMOCRATIC WORLD GOVERNMENT

Membership and/or Support

As with the major political parties, membership in the World Citizens Party depends on registration at an

official voter registration office. There are no membership dues.

____ I am registered in Massachusetts as a member of the World Citizens Party.

____ I am not presently registered as a World Citizens Party member. I support your purpose and program.

Contribution: ____$10 ____$25 ____$50 ____$100 ____Other . Please make check payable

to World Citizens Party. Note that contributions to political parties are not tax-deductible.

Mail this form (with or without contribution) to: World Citizens Party, 2161 Massachusetts Ave.

Cambridge, MA 02140-1336.

Name (PLEASE PRINT) ____________________________

Address ____________________________________________Apt.#________________

City___________________________State________Zip__________________________

Phone_________________________Email_____________________________________