FYI: LP Membership form

Libertarian Party
The Party of Principle


Please Print Clearly


Phone (home) (cell)

E-mail address

Occupation Employer

The Libertarian Party is the party of principle. To publicly affirm what we believe-and to ensure that our party never strays from our principles-we ask our members to proudly sign this statement:

I do not believe in or advocate the initiation of force as a means of achieving political or social goals.

Signature [required for membership]

Please choose a contribution level:

[ ] $25 - Sustaining [ ] $100 - Supporting [ ] $250 - Sponsor [ ] $500 - Patron [ ] $1000 - Life

Please make your check payable to the "Libertarian Party" or if you wish to pay by credit card, please fill in the following information:

[ ] Visa [ ] MasterCard [ ] American Express [ ] Discover

Account # Expiration [mo/yr]

Name as it appears on card

Libertarian Party
2600 Virginia Avenue NW, Suite 200
Washington, DC 20037

Government Mandated Notices:
The Federal Election Commission requires political committees to report the name, mailing address, your occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year. The IRS requires us to print "contributions are not tax-deductible" on all fundraising appeals.

Louise Calise

Direct Marketing Manager

Libertarian National Committee, Inc.

2600 Virginia Avenue, NW, Suite 200

Washington, DC 20037

Phone (202) 333-0008 ext. 235

Fax (202) 333-0072