Republican Women of Bossier

P. O. Box 5173

Bossier City, LA  71171-5173

 2008 Membership Application

 Name: ____________________________________________________________

 Street Address: _____________________________________________________

 City/State/Zip: ______________________________________________________

 Home Ph: ______________________     Work Ph: _____________________  

Cell Ph: _____________________       E-Mail: __________________________________________

a)  Are you a registered Republican in Bossier Parish?  Yes_____  No_____      

b)  Are you now an active member of a Republican Women’s Club? Yes______  No_____    

     If yes, with which organization? _____________________________ 

c)  Please check if you would be interested in serving on any of these committees:

Campaigns_____   Membership_____   Fundraising_____   Legislative_____   Awards_____   Telephone_____     CAP Alert_____              Community Service_____   Yearbook_____   Newsletter_____   Scrapbook_____   By-Laws_____   Publicity_____                       Americanism_____

Please mail your check made payable to:  RWB, Post Office Box 5173, Bossier City, LA  71171-5173:

$25 Active Member Fee* ______                 OR              $15 Associate Member Fee ______

*(includes membership in LA Federation of Republican Women and the National Federation of Republican Women) 

Date: ______________________     Signature:___________________________________________