Virginia Beach, Virginia 23452 (757) 486-2382 www.VirginiaBeach.gop City Committee Membership Application First Name________________________ Last Name________________________ Suffix (Sr., Jr, II) _____ Home Address___________________________________________________ Apt/Unit # ___________ City _________________ State __________ ZIP ______________ Phone (_____) ______--___________ E-mail ___________________________________ Cell Phone (____) ______--_________ Voter Precinct _______ Council Dist. _______________House Dist. ___________Senate Dist._________ Employer*__________________________ Occupation*_______________________________________ *This information required by Virginia Code for reporting purposes
I am interested in participating in the Republican Party of Virginia Beach by:
Phone Banking Working Event Booths Election Day Operations Neighborhood Canvassing Membership Fundraising Voter Outreach Event Planning Headquarters Staffing Membership Level Full Member $50.00 Associate Member $25.00 Student $15.00 I/we hereby nominate the individual listed above for membership in the Republican Party of Virginia Beach City Committee: ________________________________ _________________________ _________ Name/Signature of current member Voter Precinct Date ________________________________ ________________________ _________ Name/Signature of current member Voter Precinct Date I hereby accept my nomination to the Republican Party of Virginia Beach. I am a registered voter in the City of Virginia Beach and am qualified to participate in party actions of the Republican Party of Virginia in accordance with state party plan. Important Membership Information: Article VII, Section C of the Republican Party Plan of Organization states: A member of an Official Committee is held to a higher standard of support for nominees of the Republican Party than an individual who merely participates in a mass meeting, party canvass, convention or primary. Therefore, a member of an Official Committee is deemed to have resigned his Committee position if he (a) makes a reportable contribution to and/or (b) allows his name to be publicly used by and or (c) makes a written or other public statement in support of a candidate in opposition to a Republican nominee in a Virginia General or Special Election. Article II, Section D, 1, of the Republican Party of Virginia Beach Bylaws states: Any member except an ex-officio member shall automatically lose his or her status as a member of the City Committee who: a. Fails to attend, whether in person or by proxy, three consecutive duly called meetings; or fails to personally attend 50% of the meetings in any elected year; May 1 - April 30. b. Fails to pay his/her annual dues in accordance with the Standing Rules. As a member of the Republican Party of Virginia Beach City Committee, I understand that it is my obligation to support all Republican Nominees who appear on the ballot in a general or special election.
__________________________________________________________ _______________________________________ Signature of Applicant Date
Revised Membership Application - March, 2017 Application Received _____/_____/_____
Paid for and authorized by the Republican Party of Virginia Beach