Nelson County Republican Committee

Email*

Phone

First name*

Last name*

Address*

Apt, Unit, etc.

City*

State*

Zip*

This form only accepts US addresses.

Are you a registered voter in Nelson County, Virginia?*

YesNo

Do you agree with the Republican Creed?*

YesNo

Do you pledge to support the Republican candidates in the November general election?*

YesNo

Have you participated in the nominating process of another party in the last five years?*

I have not participated in the nominating process of another party in the last five years.I have participated in the nominating process of another party in the last five years, but I renounce affiliation with any party other than the Republican Party, intend to support the nominees of the Republican Party in the future and understand that the Nelson County Republican Committee shall provide a copy of this signed renunciation statement to the Republican Party of Virginia, to be maintained for a period of 5 years.

Requirement

I attest that all of my answers are truthful.
I will cover the processing fee of $1.15.
Nelson County Republican Committee membership dues are NOT tax deductible.
All applicants will be presented at the next regular NCRC meeting, if possible, for approval by a majority of current members.

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