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RPECC Membership Form


Your membership entitles you to request delegate/alternate status to your district caucus and the state convention.
All members will receive information about party events as well as our newsletters.
In addition, members will enjoy the privilege of full voting rights at the caucus.
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Have you been a member of the Republican Party of Eau Claire before?
Date
Please select the level of membership * Includes one Lincoln Day Dinner ticket**Includes two Lincoln Day Dinner tickets
Student ($7.50)
Regular ($15)
Regular Couple ($25/dues for 2)
Silver Club ($50/dues for 2)
Gold Club ($100/dues for 2)*
Liberty Club ($150/dues for 2)**
Platinum Club ($250/dues for 2)**
Red, White and Blue Club ($500/dues for 2)**
Patriots Club ($1000/dues for 2)**
Name
Occupation(s) and Place(s) of Employment (Required by McCain-Feingold)
Address
Town/Village/City
State
ZIP Code
Home Phone
Email Address