Republican Party of Dodge County 2017 Membership Application
Today‘s Date _______/_______/_______
City ___________________________________________State _______ Zip ________________
Home #: _______________________________ Cell Phone#:__________________________________
Where Do You Vote? Ward/Municipality__________City_______________Township____________Village______________
List memberships in other political parties or committees___________________________________
Please call Karen Gibson (920-386-3602) if you are interested in becoming a Poll Worker, Poll Observer in your municipality or if you are considering running for any local, state or national office(s). We have training available. Are you interested in volunteering to help at events, parades, fair booth, picnic, distributing signs/literature, phone calls? YES____ no______ List your choices and we will contact you: ________________________________________________________________________________________
Young Republicans age 22 and under:___ $0; Single: ____ $15 ; Couple: ____ $25 ; Family: ____ $35 Sustaining: ____ $100 ; Lincoln: ____ $250 ; Reagan:____ $500; Priceless:_____Over $500
Make checks payable to: Republican Party of Dodge County and send to:
RPDC Treasurer, W3855 Hilltop Road, Neosho WI 53059
****Please note: NEW memberships must be paid 30 days in advance of the Next Year's Winter County Caucus to allow voting at any county caucus, district caucuses, meeting or conventions.
Election laws also require us to obtain the following information from you:
Employer Name and Address: ___________________________________________________________________________________
Your Occupation _________________________________________________________________
Welcome to the Republican Party of Dodge County! We look forward to working with you for a more conservative government!