DSA Dues Waiver Request Form

Now's the time for solidarity! Financial hardship should not impact your membership. What’s most important is that you’re organizing with DSA.

Please fill out this form to request a dues waiver. You will remain a member in good standing for the next 12 months. We will be in touch before your membership expires to ask you to renew. If you have any existing recurring payments, we will cancel those for you once you fill out this form.

Not ? Click here.

First name*

Last name*

Email address*

Mobile phone

Home phone

Street address*

City*

State*

Region*

ZIP Code*

Postal code*

Country

Subscribe me to email updates (details)

If you don't subscribe, you might miss news on this campaign or future opportunities to act. (If you're already subscribed, leaving this box unchecked won't remove you.)

Mailing: Preference*

Is this a new membership or renewal?

New Renewal

If you were paying dues monthly, do you want to be contacted to restart your monthly dues?

Yes please No thank you I wasn't paying monthly dues

Are you a member of a chartered YDSA chapter? (Young Democratic Socialists of America)

Yes No

Why are you a member of DSA?

If you responded to the question above, may we quote you with your first name for recruitment purposes?

Yes, DSA is welcome to use my response. No, please do not share my response.

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