Official NKCRC Membership Request Filing Form

Official New Kent County Republican Membership Request Filing Form

One person per form.

I am applying for:

Name *

Active Duty Military?YesNo

Registered Voting Address *

City *

State

ZIP Code *

Email Address *

Phone *

Select *

Consent *

I am a legal and qualified voter of New Kent County, under the laws of the Commonwealth of Virginia, who is in accord with the principles of the Republican Party, and who attests by my signature below my intent to support all of its nominees for public office in the ensuing election. I have not participated in Virginia in the nomination process of a party other than the Republican Party in the last five years, but if I have, I now renounce affiliation with any other political party.

I agree to pay a $10.00 non-refundable fee to the NKCRC and I have read and understand the attendance policy (Article II, Section D. Absenses) set forth by the Republican Party of Virginia.

Signature *

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New Kent County Republicans Executive Committee

Jake Westbrook, Chair
Christopher Kelm, 1st Vice Chair
Leonard Erquiza, 2nd Vice Chair
George McBeath, Treasurer
Donna Temple, Recording Secretary
Rose Whitman Schooff, Corresponding Secretary

New Kent Republicans Executive Committee
P.O. Box 831
Quinton, VA 23141
(757) 876-1595
Jake Westbrook, Chair

New Kent Republicans Executive Committee P.O. Box 831, Quinton, VA 23141 (757) 876-1595 Jake Westbrook, Chair @2024