Ana and Shane Jet – Membership Renewal

Husband and Wife First Names *

Last Name *

Street Address *

City *

State *

Zip *

Cell Phone *

Email *

Is it okay to publish your email in OKCRWC Directory? *

You may opt out your email address from our annual membership directory if you wish.

Are you a member of another Republican Women's Club?

If yes, which club? If no, please put NA *

Are you a new member, returning or renewing? *

How did you learn about us? *

If one of our members referred you, what is our member's name? If you do not have a member referral, please put NA. *

By checking this box, we do hereby attest that we are registered Republicans with a valid voter ID. *

Signature *

Select and pay for your level of membership. *

Shane: Associate Membership for 3 years at $30 + Ana: Standard Membership for 3 years at $50 - $ 240.00

Total

360.00