MEMBERSHIP APPLICATION:   If you fill in your email accurately, we will answer as soon as possible.

NOTE: We do not disclose your private information to non-members.
By completing and sending this application for membership in the American Patriot Council, you certify that you have read the following membeship agreement and that it shall constitute an agreement between you and American Patriot Council, Inc.

MEMBERSHIP AGREEMENT: I hereby certify that I am legally of age, that I am a United States citizen, that I pledge allegiance to the United States of America, that my application is factual, that I have read the American Patriot Council policies as set forth in the ABOUT page of this web site, and that I agree to abide by them as long as I am a member. I understand that I may resign my membership at any time by my written authorization to take my name and address off the rolls to preserve my privacy. I also understand that any donations I may have contributed are non-refundable. I certify that my name supplied in the form below constitutes my signature to this membership agreement.

PLEASE NOTE: Only the Address-2 field is optional, all other fields are required.

First Name:Check your answers before you click the SEND button.
Last Name: Edit any field by setting the cursor there.
Address-1: Change fields with the cursor, NOT the Enter key.
Address-2: To correct a sent form, send another ---
City: the automatic date-time indicates most recent.
State: American Patriot Council is a private corporation.
Zip: Our Board reserves the right to accept or reject
Email: an application without explanation.
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