Manchester Regular Republican Club Membership Application Please Print Name___________________________________________________ Address_________________________________________________ Town_______________________ State________ Zip___________ Voting District (If Known)____________Residence Since___________ E-mail__________________________________________________ Phone________________________Cell_______________________ Registered Republican _____YES _____NO Current Annual Membership Dues Per Person $ 8.00 Please Make Checks Payable To: Manchester Republican Club P.O. Box 564 Lakehurst, NJ 08733
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Renee Savage	Chairman	araccounthound@gmail.com	732-239-1646