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To join the St. Lucie County Republican Club, print out this form and mail it along with $15.00 per person to:
SLCRC Membership
P.O. Box 4179
Fort Pierce, FL 34948



Name:___________________________________ Phone:_____________________

Street Address:_______________________________________________________

City:_________________________________ State:______ Zip:________________

E-mail Address:_______________________________________________________

If you have any comments, (i.e. nicknames, special skills, etc.) please list them below.

____________________________________________________________________

____________________________________________________________________

Make your check payable to the "St. Lucie Co. Republican Club." (Please don't send cash in the mail.)

Thank you, and we look forward to welcoming you soon!

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