SCG Republican Group Membership Application

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Dues: $20.00 per person

PLEASE PRINT LEGIBLY: All fields MUST be complete.

The completed form can be brought to any general meeting or mailed to:

SCG Republican Party SIG, PO BOX 7842, Surprise, AZ 85374

Questions Contact: Toni Helgeson at 623-680-5507 or meizel1948@gmail.com

DATE: _____/____/______

Payment: CASH_________CHECK# __________Payable to: SCG Republican Club

Zelle send to: scgrepclub24@gmail.com

Membership type: NEW________RENEWAL ________

MEMBER 1 

SCG CAM# ________________ (if applicable) 

SCG RESIDENT: Y_______ N_______

FIRST NAME_____________________________

LAST NAME______________________________________

ADDRESS (Local)____________________________________

City ________________ZIPCODE______

Home #________________________________

Cell#____________________________

MEMBER 2

 SCG CAM#_______________________(if applicable)

 SCG RESIDENT: Y_______ N_______

FIRST NAME_________________________

LAST NAME____________________________________

Home# _________________________________ 

Cell# ____________________________________

Email address Member 1______________________________________________

Email address Member 2______________________________________________

NOTE: All business-related information including meeting notifications are sent out via email. Members email

addresses are for REPUBLICAN PARTY business use only and will not be distributed to non-party organizations. It may

take up to 7 days to deposit check as we only do this weekly.