Membership Form - Loudoun County Republican Committee

Online Membership Form

Membership Type

* An Associate Member isn't required to attend meetings, nor do they have voting rights. This is for those that want to be involvee without the need to be a full member.
* Full Voting Members have attendance requirements and can't miss more than 3 meetings consecutively. They have voting rights within the committee. They MUST live in Loudoun. A regular member who no longer lives in Loudoun will be converted to an Associate Member.

Cover Processing Fees

Name

Street Address

Town/City

State

Zip Code

Home Phone

Mobile

Email Address

Last 4 digits of Social Security Number

Occupation

Employer

Town/State of Employer

I am Interested In

Nominating LCRC Member

Share Your Information

All people, regardless of race, religion, color, national origin or sex, under the laws and ordinances of Loudoun County, the Commonwealth of Virginia and the United States of America, who are in accord with the principles of the Republican Party and who express in open meeting, if requested, their intent to support all of its nominees for public office in the ensuing election, may participate as members of the Republican Party of Loudoun County, Virginia in its Mass Meetings, Party Canvasses, Conventions, or Primaries in their respective Election Districts.

Renunciation Statement

I understand that if I have participated in the nomination process of a party other than the Republican Party within the last five years, I must renounce my previous affiliation with any other political party and declare that I am in accord with the principles of the Republican Party. I further declare that it is my intent to support the nominees of the Republican Party in the future.

Agreement

Make a Donation - support our work

Cost + Fees

Total Cost

Payment

Online Membership Form

Resources

Elections

Press & News

More Information