Walton County GOP

Membership Information

                                                                     Walton County Republican Party


                                                            Membership Application

                                                                                               Family___ , Individual___,  
                                                                                            Business____,  Corporation___                                                          
                                                  Address: ________________________________
                                                   City: ____________________ Zip_____________
                                                   E Mail:__________________________________
                                                         Phone # H ___ ___ ____ , Cell# ___ ___ ____
                                                              Work#: ___ ___ ____ , FAX#: ___ ___ ____
                               Information: If you would like to get involved with our growing party here in 
                                         Walton County, just check the box below for your area of interest :
                                        ___  WILL HELP IN CANVASSING/POLLING

                                     ___   WILL HELP MAKE PHONE CALLS

                                     ___   WILL HELP WITH COMPUTER MEMBERSHIP LIST FOR COUNTY

                                     ___   INTEREST IN RUNNING FOR PUBLIC OFFICE

                                     ___   INTEREST SERVING AS A DELIGATE TO COUNTY/ STATE CONVENTION
                                                                               ___   OTHER.
                                                                         Comments: _________________________________________________________


                                                                                Annual Dues
                                $25.00 Individual, $50.00 Family , $100.00 Business/ Corp, $350.oo Patron
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e mail this form and send to the e mail address below.

                                                   you can print this form and mail your payment to
                                                                                      MAIL COMPLETED APPLICATION TO:
                                                                                                      ROY N. ROBERTS
                                                                                                          P.O. BOX 390
                                                                                                      MONROE,GA. 30655
                                        Help us help you ,by making your payment now through our new on line 
                                                                                    PayPal Account


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