Support The Southern Independence Party!

The following positions are being (or have been) recruited for this State SIP Party.  Please fill out the form below and list your preference of a job to help restore the Confederacy.  

Positions:  State Chairman,  Vice Chairman,  Vice Chairman of Communications,   Vice Chairman of Party Development, Vice Chairman of Legislative Action,  Chairman of Young Confederates, Secretary, Treasurer, County Chairman, Member.

Please provide the following contact information:  You may provide as much or as little as you deem appropriate.

Any information provided is for party use only and will be kept in confidence.

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
Your Occupation
What Party Position Interests You?
          How Would You Like  To Help?  Please check all that apply.

            Organize                                        
            Party Position
            Financial Assistance     

 Your comments here:   

P

Revised: May 27, 2001