Committee Membership Application

Committee Membership Application

PO BOX 4718, Midlothian, VA 23112 Chair@chesterfieldgop.com
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Employer*
Occupation*
I am interested in participating by:

Phone bankingNeighborhood CanvasingHaving a Yard SignWorking Event BoothsCollateral DistributionEvent PlanningElection Day OperationsFundraisingOther
If you chose other above, please let us know the details below:
Two members of the current membership should nominate you for membership. Please list their name and email below so we can contact them and obtain their signatures.
Member 1 Nominating Name*
Member 1 Nominating Email*
Member 2 Nominating Name*
Member 2 Nominating Email*
Important Membership Information:
Article VII, Section C of the Republican Party Plan of Organization states: A member of an Official Committee is held to a higher standard of support for nominees of the Republican Party than an individual who merely participates in a mass meeting, party canvass, convention or primary. Therefore, a member of an Official Committee is deemed to have resigned his Committee position if he (a) makes a reportable contribution to and/or (b) allows his name to be publicly used by and/or (c) makes a written or other public statement in support of a candidate in opposition to a Republican nominee in a Virginia General or Special Election.

Article VI, Section 6. (A) of the CCRC Bylaws states: Any member who is absent without sending a valid proxy for two (2) consecutive duly called County Committee meetings shall be notified that his membership on the Committee will lapse effective on the next duly called meeting. A person having been so notified may avoid losing membership by attending the next duly called meeting. A person having lost his membership under this subsection may apply for reinstatement to the Executive Committee or to the County Committee.

As a member of the Chesterfield County Republican Committee, I understand that it is my obligation to support all Republican Nominees who appear on the ballot in Chesterfield County.
I hereby accept my nomination to the Chesterfield County Republican Committee. I am a registered voter in Chesterfield County and am qualified to participate in party actions of the Republican Party in accordance with the State Party Plan (available online at https://virginia.gop/).
Signature*

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Regular MemberVoting Member - Attendance Required
$35.00

Associate MemberNon-Voting Member - Attendance Not Required
$35.00

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