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Movimiento Democratico Independiente Panameno (MODIPA)
For information, questions or assistance call:
(718) 513-0205  or  (718) 789-9037
 

MODIPA Membership Fee ($50)

Click here to download the form
   
Pay Online  

To pay online for your membership click on the Pay Online button below.

   
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Membership Application
Full Name:
Address:
City:
State:
Zip Code:
Country:
E-mail Address:
Phone: Cell phone:
Fax:
   
Personal Information:  
Marital Status:
Children:

Children of Panamanian born outside of Panama  who acquire a cedula are eligible to vote in Panama
Language of Preference:

  English   Spanish

Nationality

 
Cedula #

 
Occupation:

 
Are you going to register to vote?

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In order to vote, in any election, including the year 2009, a time span of one year and three months, prior to the election, is required.
   
Areas of interest:

Organizational Structure
 Voter Registration
Membership Drive
Social and Cultural Events
Education
Economics
Health

 Other Interests:
   
Suggestions, Ideas, and Concerns :

   
Please make checks payable to:

PDIM

Panamanian Independent Democratic Movement

Mail to:

P.O. Box 250-505, Brooklyn, NY 11225