Application

Date: ____________ Birthday: Month____    Day ____

Name: ______________________________________

Spouse: _____________________________________

Address: _____________________________________

Zip+4: _______________ FAX: ___________________

Phone: ______________  Business: _______________

E-mail: _______________________________________

New Membership: __________  Renewal: ___________

  Regular Membership:  $25  (Republican female, Arizona registered voter, not a member of any other Federated Republican Women's Club; includes full voting rights.)

Associate Membership:  $15  (May be a member of another Federated Republican Women's Club; no TRW club voting rights.)

Auxiliary Membership:  $5  (Republican male; shall not hold office or vote.)

Please print, complete this form,  and send with check payable to "TRW" to:

Tucson Republican Women

P.O. Box 16185

Tucson, Arizona 85732-6185
 

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