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----------------------------------------------------------Cut Here And Mail -------------------------------------------------------------Name_______________________________________________________________________ Address_____________________________________________________________________ Phone Number: Work________________________ Home____________________________ Email Address: Work________________________ Home____________________________ Occupation________________________________ Employer_________________________ Referred by (Optional) ________________________________________________________ Yes, I would like to join. Enclosed is my check for annual membership: ___$175 Single _____$275 Joint_____*$500 Sponsor _____*$1000 Director No, I cant join right now, but Id like to help with a $___________ contribution. Yes, I would like to help with the following activities: ___ Membership ___ Program ___ Publicity ___
Make checks payable to the Mercer County Capital Republican Club and send to: Mercer County Capital Republican Club, Mercer County Republican Committee, 957 Route 33, Suite 322 Hamilton Square, NJ 08690
Paid for by MCRC, 957 Route 33, Suite 322 Hamilton Square, NJ 08690 *Sponsors and Directors are listed on the Capital Republican Club letterhead.