Los Angeles Republican Clubs United
LAGOPCLUBS
About Us
Join Us
In Memoriam
Nomination Form
Beach Cities Republicans
BCR Board of Directors 2017
Peninsula Harbor Republicans
Election Information
Have You Heard Blog
Have You Heard?
Calendar
Contact Us
Editorials
Past Editorials
California GOP Organizations
Support GOP Businesses
Weblinks
Beach Cities Republicans Store
History of Ronald Reagan
History of Betsy Ross and the American Flag
Assembly Member David Hadley (66th District)
2016 Holiday Party RSVP
Current Month Flyer
Dinner Menu
Dinner Menu
* For PHR Use Only!
PENINSULA HARBOR REPUBLICANS ONLINE MEMBERSHIP APPLICATION
Choose One
*
Mr.
Miss
Ms.
Mrs.
Dr.
Hon.
Name
*
First
Last
Spouse Name
*
Home Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (If Different)
*
Line 1
Line 2
City
State
Zip Code
Country
Phone (Home)
*
Phone (Work)
*
Job Title
*
Employer
*
Membership (Select One)
*
New
Renewal
Honorary
Associate Member (Not a registered Republican)
Level (Select One)
*
Regular $25
Student $0
Family $39
Associate $39
Golden Elephant $69
Executive $99
Sponsor Member $249
Lifetime $999
Make Checks payable to: PENINSULA HARBOR REPUBLICANS
Interests (Check as many as you want)
*
Voter Registration
Get Out to Vote
School Programs
Phone Bank
Membership Building
Newsletter
Issues Research
Fundraising Events
Strategy & Planning
Writing Letters to Editor
Coalition Outreach
Other
Other Fill-In
*
I Certify that I am a Registered Republican:
Online Digital Signature
*
Date
*
I Certify that I am a Registered Republican:
Spouse Online Signature
*
Date
*
The Peninsula Harbor Republicans is a grass-roots organization. We encourage the participation of all Republicans in an honest and open forum, expressing divergent views in dialogue for the good of the Party and the Country. We unite following the Primary to support all Republican nominees in their election to office in the General Election.
We believe in the protection of individual and property rights, fiscal restraint, and smaller government. If you are interested in learning more, please complete this form and send it to the address shown above.
Extra Donations help fund the grass roots Get Out the Vote and Voter Registration Activities needed to elect Republican Candidates.
Before you click on Submit (Please Print this Online Application and mail with your check)
Return Application to: PHR, 2135 Paseo Del Mar, San Pedro, CA 90732
Submit PHR Membership Application
✕
