Membership Form

Full Name*

First NameLast NameSuffix

Email Address*

example@example.com

Mobile Number*

Please enter a valid phone number.

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Interests

Preferred Membership Benefits

My Products

Active MembershipActive Members must be between the ages of 18 and 40, registered Republican, and a Florida resident. Membership auto-renews annually.

$30.00

Active Membership - Hero/StudentFor Active Members who are either Undergraduate students, active Military, Veterans, First Responders, or Healthcare workers. Membership auto-renews annually.

$20.00

Active Membership - CouplesBoth Members must qualify for Active status. Membership will auto-renew annually.

$50.00

Associate MembershipFor Members who do not meet the qualifications for Active Membership (age, location, etc.). Membership auto-renews annually.

$25.00

Associate Membership - Hero/StudentFor Members who do not meet the qualifications for Active Membership (age, location, etc.) and are either Undergraduate students, active Military, Veterans, First Responders, or Healthcare workers

$15.00

Associate Membership - High SchoolFor Members who currently attend high school and are under 18 years of age. Membership auto-renews annually.

$10.00

Associate Membership - CouplesFor Members who do not meet the qualifications for Active Membership (age, location, etc.). Membership will auto-renew annually.

$45.00

By joining the Treasure Coast Young Republicans, you also become a member of the Florida Young Republicans. The Florida YRs are chartered through the Republican National Committee and the Young Republican National Federation.