Join Our Club – Republican Club of Solivita

Membership Type *

Last Name *

First Name - 1 *

Cell Phone - 1 *

Birthday - 1

Email Address - 1 *

First Name - 2

Cell Phone - 2

Birthday - 2

Email Address - 2

Local Home Address *

Poinciana, FL 34759

Home Phone

Annual dues are $15 per person. Checks should be made payable to RCS or Republican Club of Solivita. Your annual membership is due for renewal and dues payment every year in January.

Enter total dues for membership here: *

USD

If you wish, you may add to your dues, a donation to the education/scholarship fund here:

USD

Total check amount to be submitted with your application:

$

To complete your membership, enclose in an envelope, your check and the form you will receive from us by email after clicking on the red bar below.

Please don't forget to print out and include the form you will receive from us by email with your check or we will not have all of your contact information.

You can drop off the envelope at an RCS ticket sales event, RCS meeting, or mail it to the following address:

Republican Club of Solivita
P.O. Box 580286
Poinciana, FL 34758