REPUBLICAN PARTY OF VIRGINIA BEACH

2955 Virginia Beach Boulevard, Suite 105

Virginia Beach, Virginia 23452
(757) 486-2382
www.VirginiaBeach.gop
City Committee Membership Application
First Name________________________ Last Name________________________ Suffix (Sr., Jr, II) _____
Home Address___________________________________________________ Apt/Unit # ___________
City _________________ State __________ ZIP ______________ Phone (_____) ______--___________
E-mail ___________________________________ Cell Phone (____) ______--_________
Voter Precinct _______ Council Dist. _______________House Dist. ___________Senate Dist._________
Employer*__________________________ Occupation*_______________________________________
*This information required by Virginia Code for reporting purposes

I am interested in participating in the Republican Party of Virginia Beach by:

Phone Banking Working Event Booths Election Day Operations Neighborhood Canvassing
Membership Fundraising Voter Outreach Event Planning Headquarters Staffing
Membership Level Full Member $50.00 Associate Member $25.00 Student $15.00
I/we hereby nominate the individual listed above for membership in the Republican Party of Virginia
Beach City Committee:
________________________________ _________________________ _________
Name/Signature of current member Voter Precinct Date
________________________________ ________________________ _________
Name/Signature of current member Voter Precinct Date
I hereby accept my nomination to the Republican Party of Virginia Beach. I am a registered voter in the City of
Virginia Beach and am qualified to participate in party actions of the Republican Party of Virginia in accordance
with state party plan.
Important Membership Information:
Article VII, Section C of the Republican Party Plan of Organization states: A member of an Official Committee is held to a
higher standard of support for nominees of the Republican Party than an individual who merely participates in a mass
meeting, party canvass, convention or primary. Therefore, a member of an Official Committee is deemed to have resigned his
Committee position if he (a) makes a reportable contribution to and/or (b) allows his name to be publicly used by and or (c)
makes a written or other public statement in support of a candidate in opposition to a Republican nominee in a Virginia
General or Special Election.
Article II, Section D, 1, of the Republican Party of Virginia Beach Bylaws states: Any member except an ex-officio member
shall automatically lose his or her status as a member of the City Committee who: a. Fails to attend, whether in person or by
proxy, three consecutive duly called meetings; or fails to personally attend 50% of the meetings in any elected year; May 1 -
April 30. b. Fails to pay his/her annual dues in accordance with the Standing Rules.
As a member of the Republican Party of Virginia Beach City Committee, I understand that it is my obligation to support all
Republican Nominees who appear on the ballot in a general or special election.

__________________________________________________________ _______________________________________
Signature of Applicant Date

Revised Membership Application - March, 2017 Application Received _____/_____/_____

Paid for and authorized by the Republican Party of Virginia Beach