Membership Form
Bloomfield Republican Women's Club

2010 Membership Dues:       $30.00 

Please fill in the form below (the info you give in the first 5 lines will be put in our directory) and send it with your check payable to Bloomfield RWC to:

Bloomfield RWC ATTN:  Aleta Moffitt
1832 Fox Run
Rochester Hills, MI 48306

Questions?     Call:  248-608-8035 

                        E-Mail:  ahmoffo@aol.com                     
 
Member Information             __ I am a returning member              __ I am a new member

Name________________________________________Spouse_____________________________
                    
Address_________________________________________________________________________

City, State, Zip___________________________________________________________________

Home Phone:____________________________________________________________________

Business Phone __________________________E-Mail _________________________________

 __ I DO NOT want to receive information via e-mail.

In ADDITION to my membership dues, I am enclosing __$25 __$50 __$75 to help the Bloomfield Republican Women’s Club continue to spread the conservative message.
 

Republican Women’s Club Memberships;:

If you are a member of another Republican Women’s Club, you must be a voting member in only one club, and an associate member of the other clubs.  Please indicate below whether you would like to be a voting member in this club, and list any other Republican Women’s Clubs of which you are a member.

I would like to be a __ voting member __ associate member in the Bloomfield Republican Women’s Club.

Please list any other Republican Women’s Club in which you are a member ___________________________

Volunteer Opportunities

I will volunteer for __ publicity __ mailing __ telephone __ serve on board __ hospitality __ newsletter
__ work on club directory __ serve on committee
 
Please list any talents you are willing to share (i.e. computer skills, musical/artistic/creative, accounting/finance, literary, etc.)