Official NKCRC Associate Membership Filing Form Name: Mr./Mrs./Ms./Rank (Required) *Active Duty Military? *YesNoRegistered Voting Address*CityStateZIP CodeMailing Address (Required only if different)CityStateZIP CodePhoneEmail AddressI HEREBY APPLY FORNKCRC Associate Membership (non-voting)NKCRC Membership (voting member - When a voting membership becomes available we will notify you at that time)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.Signature (required)DateSubmit
