VIRGINIA BEACH REPUBLICAN WOMEN'S CLUB MEMBERSHIP FORM

Virginia Beach Republican Women's Club Membership Form

Payment Type

First Name

Last Name

Address

City

State

Zip Code

Phone #

Format: (000) 000-0000.

Email Address

example@example.com

Spouse Name

Are you a registered voter?

If yes, what is your voting precinct/location?

How did you hear about VBRWC?

Volunteer Interest - please check all that apply

*Our God given right to life, liberty, and the pursuit of happiness

*Our freedom and the knowledge that it cannot be stolen by anyone, including those in the government

*Fiscal accountability and individual responsibility for actions

*A free enterprise system where opportunities abound

*A school system reflective of parental rights

*Peace preserved by a strong military arm

*Faith of our forefathers who fought for the nation, the state, and their community

Welcome to Virginia Beach Republican Women's Club - Right since 1959

Signature

Date

Membership Dues

$50 + $2 processing fee

$52.00

Associate Membership Dues

$25 + $2 processing fee

$27.00

Total