Join Us

Submitted by idp_admin on Wed, 09/17/2008 - 03:08.
Iran Democracy Plan Membership
MEMBER INFORMATION   INSTRUCTIONS
Prefix
First Name *
Middle Name
Last Name *
Suffix
Email Address *
 
 
* Required Information
 
Address *
City *
State *
ZIP Code *
Country
Telephone

 

Please give us this information to join the Iran Democracy Plan and pledge your support.

 
REFERRALS INSTRUCTIONS
Referral 1
Referral 2
Referral 3

Please refer three people who may be interested in joining IDP

For each referral, please provide name and contact information

 
SUGGESTIONS INSTRUCTIONS
Suggested activities or anything else

Please let us know your thoughts

 
MEMBERSHIP OPTIONS INSTRUCTIONS
Membership Type
Standard-Annual - $100.00
Standard-Annual - $250.00
Standard-Annual - $500.00
Standard-Annual - $1,200.00
Standard-Annual - $5,000.00
Trustee - $10,000.00
Other -

Please choose the membership level at which you would like to join. This is a "pledge", and we will contact you. Monthly payment options are available.

Make sure all the applicable information in the form is filled out and press the "Send" button below:

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