To join Southwestern Young Republican Club, fill out the following form, attach a check, and mail it to:

Ronald D. Richmond

2055 South State Rt. 133

Blanchester OH 45107-8480

Name: ___________________________________

Address: ___________________________________

City: _____________________ ZIP: _________

Phone (h): (____)____-_____ (w): (____)____-_____

E-Mail: ___________________ DOB: ___/___/___

Member benefits include discount rates at YR meetings and other party functions, free subscription to The Southwestern Quarterback, member ID card, and much more! Be sure to ask about discounts and special rates on dues.

( ) I would like to join as a regular member, $20

( ) I and my spouse would like to join as a couple, $30

( ) I would also like to help recruit members in my area.

I would like to join as a sustaining member (with benefits):

( ) Steve Chabot, $35

( ) Calvin Coolidge, $50

( ) Teddy Roosevelt, $75

( ) Abraham Lincoln, $100

( ) Robert Taft Sr., $200 or more

Comments:

You can contact us by sending an email message to: syrc@usa.net

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