Republican Party of Virginia Beach RPVB Membership Application

Republican Party of Virginia Beach RPVB Membership Application
Form Version Date: August 2023
Complete this application form and submit your payment information for your desired level of membership. RPVB will contact you with instructions to confirm your application. Membership is a two part process where candidates are presented as nominees at one committee meeting and elected into the party at the next committee meeting.

The City Committee Meeting is the second Monday each month and meets at the Law Enforcement Training Academy (LETA), 411 Integrity Way, Virginia Beach 23451.

Indicate Desired Membership Level (New or Renewal) If applying as a married couple please select quantity 2 and enter both first names in the applicable field.*

New Membership

$50.00 Quantity
Item subtotal:$0.00

Renew Membership

$50.00 Quantity
Item subtotal:$0.00

New Associate Membership

$25.00 Quantity
Item subtotal:$0.00

Renew Associate Membership

$25.00 Quantity

High School Student Membership

$15.00 Quantity

Renew High School Student Membership

$15.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Indicate Desired Membership Level (New or Renewal)*

Renew City Committee Membership $50 Renewable Annually (Voting)Renew City Committee Associate Membership $25 Renewable Annually (Non Voting)Renew City Committee HS Student Membership $15 Renewable Annually (Non Voting)New City Committee Membership $50 Renewable Annually (Voting)New City Committee Associate Membership $25 Renewable Annually (Non Voting)New City Committee HS Student Membership $15 Renewable Annually (Non Voting)
Name*

First Name(s) - If applying as a married couple please enter both names in this field i.e. John & Susan.Last Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Your Legislative District and Polling Precinct
Please indicate your polling precinct. If you don't know this information, please use this link*: Polling Location Lookup.

If you cannot determine your information using the link, RPVB will determine this information for you later. This information is not required to submit this form.
Enter your polling precinct information below:

Polling Precinct

Enter Polling Precinct Location*
What Committees are you interested in?
Please select a desired committee(s).*

OfficeBylawsCampaignsCommunicationsEvent PlanningFundraisingMembershipVoter OutreachOther
Oath
I affirm that I am a registered voter of Virginia Beach and support Republican values and candidates.

As a member of the Republican Party of Virginia Beach City Committee, I understand that it is my obligation to support all Republican Nominees who appear on the ballot in a general or special elections
I affirm my dedication to the Republican Creed and Oath to Party membership.*

YesNo
Signature

Clear
DateTime
Employer Information Required for Campaign Finance Reporting Laws. If you are retired check the Retired Box. There is no requirement to enter employer information.
I am

Retired
List Employer. *
I understand my information will be used only for City Committee Official Business. I give my permission to release my personal information to other City Committee Members.*

YesNo
If you are having difficulty submitting this form at RPVB.org then please try this direct link:

RPVB Membership
Paid and Authorized by the Republican Party of Virginia Beach

RPVB Headquarters 2955 Virginia Beach Blvd #105, Virginia Beach, VA 23452. Open Monday - Friday 10AM - 4PM. Telephone 757 486 2382.
Should be Empty:

Republican Party of Virginia Beach RPVB Membership Application

Your Legislative District and Polling Precinct

What Committees are you interested in?