test membership form

CONTACT INFORMATION

Pay By Check

Name*

Birthday*

Street Address*

City/State*

Zip Code*

Home Phone*

Work Phone

Cell

Fax

Must have at least one phone number so we can reach you

Email Address*

Emergency Contact Name and Phone*

Type of MembershipNew $45Renewal $45$42 - Pay before 02/01/21Associate $25

Register Republican?YesNo (must be registered Republican to be a Member)

Regular Member of another Federated Club?YesNo

If “yes” name of other Club

Interest: Tell us in which areas you are interested in volunteering*Executive Board MemberFirst Vice PresidentSecond Vice President ProgramsThird Vice President MembershipFourth Vice President Ways & MeansAmericanismChaplainSunshineLegislatureNewsletter EditorParliamentarianPublicityHoliday EleganceTelephone TreeVoter registrationWebsiteSocial MediaOther

Make your registration/renewal checks payable to:
"CRWF"
Mail to:
Chico Republican Women Federated
PO Box 6553, Chico CA 95927