Nashua Area Republican City Comittee Membership Questionnaire

Nashua Area Republican
City Committee

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Membership Form

Nashua Area Republican City Committee
Membership Form
(Download PDF vestion of this form)

*You can make dues membership payments online or by filling out the form below and mailing your check.

Members: 2010 dues are now due!

Name(s): Date:

You may list my name as a supporter of the Nashua Republican City Committee.
I would like to become a member of the NRCC. I am registered to vote: Republican Undeclared

Dues/Donation: $500 $250 $100 $50 $25 $15 Family $10 Individual
A suggested donation of $10 per member or $15 per family will be appreciated.
If you are able to contribute more please do. Thank you!

Your e-mail Address #1

All email addresses are kept private.

Your e-mail Address #2

Street/PO Box

Your Mailing Address(s)

City/Town

State Zip

Ward

Phone (D)

Phone (N)

Cell

Voting address (If different than mailing address):

Street:

City/Town:

State: Zip:

I can help!

Making phone calls Help with mailings Help at events Computer skills Recruiting Members Writing letters to the editor Maintaining voter lists Ward captain
I can also help by:

In the space provided, please describe any issues that are of particular interest to you and how you can help the Committee and our party. Please use the back for additional comments.

Please fill out this page and 'submit' it and then mail your check to the address below, or print this page, fill it out and mail it along with your check to: NRCC Membership, c/o Dennis Hogan, 11 Concord Street, Nashua, NH 03060
Please make your check out to "NRCC". Thank you!

Paid for by the Nashua Area Republican City Committee
Not authorized by any candidate or candidate committee