Nashua Area Republican City Comittee Membership Questionnaire

Nashua Area Republican
City Committee

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Nashua Area Republican City Committee

Membership Questionnaire

Please fill in the following information:

Section A: Member Name

Last Name: First Name: (MI)

Section B: Party Affliiation

Republican Democrat Undeclared

Section C: Residence Address

Street:
City:		State:
Zip Code:
Ward:

Telephone:
E-Mail Address:

Please use my e-mail address only for internal Nashua Area Repulican City Committee communications.

Section D: Mailing address (If different than Sect. C)

Street:
City:	, NH	Zip Code:

Section E: Committees/Special Interests (Optional)

Membership
Communication and Publicity
Campaign
Ad Hoc Committees formed by the Chairman

In the space provided, please describe any issues that are of particlar interest to you:


Print this page and either fax to Liz Christoffersen at 603-886-0004 or mail to: c/o Carl Seidel 4 Thresher Road Nashua, NH 03063

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Not authorized by any candidate or candidate committee