For Nominating Committee Only

Recommended? Yes No

Dues Paid? Yes No

The Republican Party of Chesapeake

Application for Membership (New or Renewal)
Please return this application to;
Irene Hurst, Membership Committee Chair
1309 Oleander Ave., Chesapeake, VA 23325

Name: ________________________________________ E-mail:________________________________________

Address: _______________________________________ Chesapeake, VA. Zip: ___________________________
Precinct (from Voter Registration Card):___________________________________________________________
Telephone # (H): _______________________ (W): ______________________ (C): ________________________
I (name) ____________________________________________ am in accord with the principles of the Republican Party as stated in
the Virginia Republican creed:

That the free enterprise system is the most productive

supplier of human needs and economic justice,
That all individuals are entitled to equal rights, justice
and opportunities and should assume their
responsibilities as citizens in a free society,
That fiscal responsibility and budgetary restraints must
be exercised at all levels of government,

That the Federal Government must preserve individual

liberty by observing constitutional limitations,
That peace is best preserved through a strong national
defense,
That Faith in God, as recognized by our Founding
Fathers is essential to the moral fiber of the Nation.

And will support all endorsed and nominated Republican candidates during my term of membership.
I will also abide by the rules and bylaws of the Republican Party of Virginia and the Republican Party of Chesapeake, Inc.
I authorize the RPC to send me Party Calls to meetings and other official correspondence via e-mail to the address above (strike out
if you are not willing/do not wish to receive notifications & correspondence via E-mail)
And, I acknowledge that I must be present when my nomination for membership is voted upon and that my term of election will
expire at the next mass meeting, Party Canvass Convention, or Primary called for the purpose of electing delegates to the Biennial
District Convention.

Signature: __________________________________________________ Date: ___________________________

RPC Sponsor (1): _____________________________ RPC Sponsor (2): __________________________________
Please indicate which activities interest you:
Phone Banking
Fundraising
Poll Watcher/Worker
1.

2.

Computer Operations
Membership Recruitment
Event Organization

Candidate Development
Newsletter Publication
Precinct Organization

Literature Drops
Sign Placement
Other_________________

All legal and qualified voters, regardless of race, religion, color, national origin, or sex, who reside in the City of Chesapeake, who are in accord with the
principals of the Republican party, and who, if requested, express in open meeting, either orally or in writing, their intent to support all Republican
nominees for public office in the ensuing election, may participate as member of the Republican Party of Chesapeake in its mass meetings, party
canvasses, conventions, or primaries, encompassing their respective election districts, and are eligible for membership in the Chesapeake City Committee.
A person who has made application for registration and meets all other requirements of Paragraph 1, but whose name does not appear on the local
registration books solely because the books have been closed in connection with a local election, will nevertheless be deemed a legal and qualified voter.

2014 Republican Party of Chesapeake