Membership Application
www.CherryTreeGOP.org
Your Name
First Name
Last Name
Your Email
example@example.com
Your Phone
Please enter a valid cell phone number.
Your Occupation?
Occupation
Your Birthday
-
Month
-
Day
Year
Birthday
Spouse Name
First Name
Last Name
Spouse Email
example@example.com
Spouse Phone
Please enter a valid cell phone number.
Spouse Occupation
Spouse Occupation
Spouse Birthday
-
Month
-
Day
Year
Birthday
Address
*
Street Address
Street Address Line 2
City
Please Select
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District of Columbia
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Ohio
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Oregon
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Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Subdivision Name
*
Your residence subdivision name
Elected Official (position?)
Are you an elected official? If yes what position?
How did you hear about us?
*
Where did you hear about us from?
Please indicate area to volunteer according to your skills and desires to help:
Membership
Meeting Protocol
Greeter
Website
Event Planning
Fundraising
Telephone
Photography
Other
Yearly Dues, please check one:
*
Individual New $25
Individual Renewal $25
Family New $35
Family Renewal $35
Student New $15
Student Renewal $15
Please check if you want a name tag(S)
Name TAG1 $12
Name TAG2 $12
It is customary for clubs to publish or share membership lists with club members, i.e., newsletters or directories. Please indicate if you wish to "OPT In" or "OPT Out" here by selecting one.
*
Please Select
OPT In membership list
OPT Out membership list
Select option from the pull-down
PAY HERE FOR ITEMS CHECK ABOVE:
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INDIVIDUAL MEMBERSHIP
$
25.00
FAMILY MEMBERSHIP
$
35.00
STUDENT MEMBERSHIP
UNDER 18
$
15.00
NAME TAG
$
12.00
NAME TAG
$
12.00
Credit Card
Submit
www.CherryTreeGOP.org
For more information please contact: Anne Bly, Treasurer, 832-677-7711, weryy4u@att.net . Political contributions are not deductible for federal income tax purposes. Corporate contributions are not permitted. Political advertising paid for by Cherry Tree Republicans.
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