RAPIDES REPUBLICAN PARISH EXECUTIVE COMMITTEE

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The following form may seem intrusive, but the information is vital to us and all data will remain private.  Moreover, it will help reduce the cost of mailing printed material and will make it easier to organize and to canvass neighborhoods.

*  Please ensure precinct # is indicated!


NAME (as it appears on the voter rolls): 

STREET ADDRESS: 

MAILING ADDRESS (if different): 

TELEPHONE (please include area code):
Home:   
Work: 
Mobile: 
Fax: 

E-MAIL ADDRESS: 

*  PRECINCT #: 

POLITICAL PARTY REGISTRATION: 

SPOUSE (as the name appears on the voter rolls): 

SPOUSE'S POLITICAL PARTY REGISTRATION: 

OTHER REGISTERED VOTERS IN HOUSEHOLD
(as the names appear on the voter rolls; indicate party registration with R, D, L, I, or O after each name):

AREAS OF INTEREST (please check all that apply):
Precinct Captain
Precinct telephone tree
Neighborhood canvassing during campaigns
Working at campaign headquarters
Poll watching on election days
Helping with voter registration drives
Campaign yard signs/bumper stickers (personal)
Available locations for large signs/ads
Transporting and placing yard signs and large signs (approved locations)

 

THANK YOU!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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