BECOME A MEMBER!

Yes! I want to join Iowa Citizens for Community Improvement and be a part of working for social, economic and environmental justice.

Simply print the form below, fill it out and mail it with your check (made payable to Iowa CCI) to:

Iowa Citizens for Community Improvement
2001 Forest Avenue
Des Moines, IA 50311

Donation Amount:

___$25 (Individual) ___ $35 (Family) ___$60 (Contributor) ___$100 (Supporter)

Please apply my dues to: (select only one)

____Rural ____Des Moines ___Latinos en Accion ___Voter-Owned Election

Name and Address:

Name _______________________________________________

Address _____________________________________________

Town/State/Zip _______________________________________

Phone ______________________________________________

Email _______________________________________________

I heard about Iowa CCI from: ____________________________