High School Centrist Volunteer and Membership Form

This form is for those who are high schoolers who are at least 16 years of age to join the American Centrist Party and/or to volunteer to set up High School Centrist organizations around America.

I am at least 16 years of age and enrolled in High School or a GED program.

Yes No

Date of Birth ( Month, Day, Year) ( Required)

I am filling this out to join the American Centrist Party and have a Parents or Guardians permission, if under age 18.

Yes No

Full Name (Required)

Mailing Address, State, City, Zip Code (Required)

Email Address ( Required)

Phone Number/s with area code (Not Required, but helpful for contact and organizational purposes)

I am interested in starting up a High School Centrist Organization at my school.

Yes, and send me more information No Maybe, send me more information

Any information collected and processed is treated with the utmost confidentiality. We will not sell or rent out any personal information gathered from members.