JOIN THE REPUBLICAN PARTY OF CLARK COUNTY

The Republican Party of Clark County (RPCC) is a unified body of citizens who have come together to defend and reclaim the virtues of our republic. It is clear that our republic is under assault by persons who do not hold the same values that we hold. We believe that by presenting a united front we can reclaim the principles that the founding fathers established.

“United we stand, divided we fall” Abraham Lincoln

We encourage all conservatives to join us as we move to take back the political ground that we have given up in recent years. We know that the majority of Americans still hold the traditional values of faith, family and freedom that are the foundation of our republic.

REPUBLICAN PARTY OF CLARK COUNTY MEMBERSHIP APPLICATION

_____Membership Renewal ______New Member ______Change of Address

Suggested Annual Membership Dues; January 1 through December 31

_____$15 Individual _____$25 Couple _____$25 Associate Member (non resident)

__________Amount Paid

Name________________________________________________________________

Address_______________________________________________________________

City _________________________________State__________ Zip Code___________

Home Phone ______________Work Phone ______________ Email________________

I affirm that I am eligible to vote in any national or state election, and believe in the objectives, purposes and principles of the Republican Party; and will preserve our Republican form of government as created under the Constitution of the United States and the Constitution of Wisconsin.

Signed_______________________________________________Date______________

Make checks payable to:

Republican Party Clark County

Count on me to help with:

_____membership _____phone calls ____ yard signs

_____mailings _____fair booth ____fund raiser

_____special events _____other ______________

Optional: State law requires that we ask your occupation and employer’s name and address, if your contributions total $100 or more in a year.

Occupation_________________Employer_______________________________

Employer’s Address__________________________________________________

Authorized and paid for by Republican Party Clark County, Lynn Strickland, Treasurer

HEAD QUARTERS

3119 HYW G

GREENWOOD, WI 54437

P.O. BOX 5