APPLICATION FOR MEMBERSHIP

Any woman, registered as a Republican, who believes in the principles of the Republican Party and intends to support its candidates is eligible for membership, when sponsored by a member of The Belleair Women's Republican Club.  Male members are very welcome as sustaining members.

NAME:  __________________________________________________

ADDRESS:  _______________________________________________

CITY/STATE/ZIP:  _______________________________________

TELEPHONE NUMBER  :_________________________________

CELL PHONE NUMBER:  ________________________________

EMAIL:  ________________________________________________

SPONSOR'S NAME:  ______________________________________

REGISTERED REPUBLICAN:  ___YES  ___NO

PRECINCT NUMBER:  ____

I am interested in helping, and would be willing to do the following:

___1.  Telephoning

___2.  Help Republican Candidates

___3.  Help at the Pinellas Republican Executive Committee

___4.  Run for office within the club.

___5.  Other duties in the Club (newsletter, publicity, help with fund raising).

My computer skills are  _________Excellent   __________Good  ___________Fair  ______________ Poor


ANNUAL DUES:  $1.00 (This year only) January-December                    

__________________________
SIGNATURE

Please make your check payable to B.W.R.C. and bring it with you to the next meeting, or mail to 
Claudia Thomas
5512 Salem Square Drive N
Palm Harbor, FL 34685




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