2007 Membership Application
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  Yes, I am a registered Republican.

Name:
Address:
City:		State:		Zip Code:	9-Digit Please
Home Phone	Area Code & Number	Office Phone	Area Code & Number
Fax Line	Area Code & Number	Cell Phone	Area Code & Number
Email
Occupation
Employer

Congressional District		Legislative District
Council District		Precinct
This information can be obtained from your Voter Registration Card or by calling the Anne Arundel County Board of Election Supervisors at: 410-222-6600.

Areas of interest (check as many as you wish):

Address/Stuff Envelopes	Awards
Fundraising	Political Issues/Legislation/Education
No Child Left Behind/Literacy	Voter Registration
Community Service/Caring for America	Headquarters (MDGOP/White House)
Administrative Help	Campaigns
Hospitality	Membership
Precinct Organization	Programs
Publicity

Choose one:

  Regular Membership $30
  Associate $20 (Women who are members of another MFRW affiliated organization or Men)
  Sustaining Member $55
  Patron $110
  Life Membership $550

Please mail the completed form along with a check for your dues to:

Mary Fink, RWAAC Membership Chairman
1202 Waterton Court
Pasadena, MD 21122-2304