Polk County Republican Women Membership Form
"One Plus One"
"Recruit, Reactivate and Retain"
Please Print:
Name ________________________________________________
Address ________________________________________________
________________________________________________
City
State Zip
Home Phone ____________________Work__________Cell_________
Email Address ______________________________________________
Dues:
$20 Seniors & Student Special (Seniors are 65 & above,
Students up to age 25)
$25 Regular
Dues Distribution:
NFRW $8.00
IFRW $7.00
PCRW $5-$10 (PCRW Programs and Republican
Candidate Contributions)
All dues are payable to Polk County Republican Women to be placed in the
general fund that supports republican candidates running for elected offices.
Each year a small nominal check is written to various republican Iowa candidates
in support of their campaigns.
During this membership cycle a new category has been added in alignment with
the National Federal of Republican Women and that is Associate Member at the
same rate. Often times there are those who support the party's platform, but do
not have time to attend meetings and events but would like to contribute to help
elect republicans on a regular basis. Then if this is your current situation,
perhaps you may wish to be considered as an associate member. We encourage
husbands, neighbors and friends to become associate members.
Please check the area you are interested in being a part of when special
committees are set up.
_____Style Show Committee is a special committee activated to help
plan the annual fundraiser. Committee members decide theme, cost and place as
well as help with the total logistics of the style show.
_____Phone Tree Committee is a special committee that is set up to
phone members across the county to remind them of important events.
_____Volunteer Committee is a special committee set up to help solicit
volunteers for various republican events by making phone calls, writing letters
or soliciting assistance from various republican groups.
_____Legislative Day Committee is a special committee set up to assist
IFRW in planning the legislative day on the help which may include helping with
logistics and public relations.
_____Other is for any special interests that you have that may not be
listed but would like to volunteer your time.
PLEASE COMPLETE AND RETURN THIS APPLICATION ALONG WITH YOUR CHECK OF $20
or $25 MADE PAYABLE TO POLK COUNTY REPUBLICAN WOMEN.
Please check your category of interest _____ Member Or
Associate _____
MAIL TO:
Attn: Mary Jean Paschen, Membership Chair
2501 82nd Street
Urbandale, Iowa 50322
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