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Membership Application (Please Print) |
| Name: | ________________________________________________________ |
| Phone Number: | (Day)______________________ (Evening)______________________ |
| Address: | ________________________________________________________ |
| ________________________________________________________ | |
| Email Address: | ________________________________________________________ |
| Precinct: | _________________ |
| Are you a registered Republican? _______ | (Per Article III of the Charter you must be a registered Republican to be a member of the Club) |
| Would you be willing to help make phone calls for the Club? ______ | |
| What issues concern you the most about the town of Davie or Cooper City? | |
| Signature: | _____________________________________ | Date: | ____________ |
Yearly membership is from January 1st through December 31st:
$30.00 for married couples' membership $10.00 for students $10.00 for member over the age of 65 |
Make your check payable to: Republican Club of Davie/Cooper City Mail your check and application to:
c/o Ken Jennings 481 Sumter Avenue Davie, FL 33325 |