Membership Application 

 [To apply for membership in the Expansionist Party of the United States,
print this page, fill it in, keep a copy for your records, mail to L. Craig Schoonmaker, Chairman,
Expansionist Party of the United States, 295 Smith Street, Newark, New Jersey 07106-2517,
UNITED STATES, and enclose your remittance of the proper dues, in U.S. funds.]

I support the goal of a wider union under the Constitution of the United States.

¨  Please enroll me as a member of the Expansionist Party. I enclose check or money order in U.S. funds in payment of
     ¨ Regular
     ¨ Student (I affirm that I am a duly-enrolled student in an accredited school or college.)
     ¨ Senior
Membership for the year ending July 3, 2____.

¨ Please also accept an additional contribution of US$_________ toward XP's work.

¨ Please send me information on forming a local chapter of XP.

¨ I'd like to help with mailings and other activities when convenient. Please contact me.

I'm not sure I want to join XP at this time, but I do want to contribute US$_________ toward your work. Please
¨ add me to your mailing list
¨ do not add me to your mailing list.

Name: _________________________________________________________________

Postal Address: __________________________________________________________

                         __________________________________________________________

E-mail Address: __________________________________________________________

Telephone Number: _______________________________________________________
(Optional)                (Include area code / country and city codes)

Signature: _______________________________________________________________

(Make remittances payable, in U.S. funds, to "L. Craig Schoonmaker" (with notation in the Memo area, "For the Expansionist Party"), in that bank charges for small organizations are so high that XP does not maintain its own accounts. We'd rather all dues and contributions go to XP activities (such as maintaining our website), rather than see a substantial portion go instead to exploitative banking institutions.)

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visits since September 17, 2005