MEMBERSHIP APPLICATION

Dues are paid on a calendar year basis. Family dues are $8.00 and Individual dues are $5.00. If you would like to join please print this notice, fill it in and return it with a check payable to:

East Fishkill Republican Club
PO Box 524
Hopewell Jct., NY 12533

Name(s)___________________________

Address___________________________

City, State, Zip_____________________

E-Mail ___________________________

Amount Paid $8.00______$5.00_______