THE GREATER MCLEAN REPUBLICAN WOMEN'S CLUB

MEMBERSHIP FORM FOR 2008 NEW MEMBERS AND RENEWALS

GMRWC Members are dedicated to:

Please make your check payable to GMRWC and mail it, along with this form to GMRWC, P.O. Box 417, McLean, VA 22101-0417.

Regular Member: $40 dues_____. Asssociate Member: $25 dues____.
You must be a regular member of another Federated Republican Women's Club to qualify for this rate.

I would also like to make a donation to the club. Enclosed is my contribution:____________

Full Name (Nickname):__________________________________________________

Spouse Name:___________________________________________________________

Home Address:__________________________________________________________

Precinct:______________________________________________________________

Home Phone:____________________________________________________________

FAX:___________________________________________________________________

E-mail:________________________________________________________________

Employer:______________________________________________________________

Work Phone:____________________________________________________________