Houston Professional
Republican Women
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Houston Professional Republican Women 2008 Membership Form
The Houston Professional Republican Women PAC is a federated organization of the Texas Federation of Republican Women and the National Federation of Republican Women. Our members are professional women and men in many fields – all interested in educating themselves about the political process and in providing strength and unity for political action within the Republican Party of Texas.
Please enter the following information:
Name: _______________________________ Spouse: __________________
Street Address: ___________________________________ Occupation: _______________
County of Residence:__________________________________ Voting Precinct: _____________
Registered Voter: Yes No Precinct Chairman? Yes No
E-mail Address: ___________________________________________
Preferred Method of Communication: Email Snail Mail Home Phone Office Phone
2008 Dues: Now Due __$28 Full __$15 Associate Member since: ___________
For Female Associate Members only, Primary Club: _____________________________________ Name TagI would like to have a personalized HPRW name tag for $12.50?. Yes ____ No ____ Computer SkillsAre you proficient in any of the following? MS Word ____ MS Excel ____ Desktop Publishing ____ Websites _____ Other ____________
Please make your check payable to HPRW PAC and mail to: Ms. Tomi Porterfield, 803 Birchview Court, Pearland, TX 77584
Dues Received by: ________________________ Date: ________________
Pol Adv paid by HPRW PAC Contributions not deductible for Federal Income Tax purposes. Corporate contributions not permitted.
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