Mail this form with your $40* check,
payable to Dallas Downtown Republican Women’s Club,
to Mary Silva, PAC Treasurer, P.O. Box 600503, Dallas, TX 75360



                              First                Middle Initial             Spouse     


Address __________________________________________________________________

                              Street                                         City                                      Zip (9 Digits)


Telephone ______________________________________________________________

                             Home - Area Code/Number        Work - Area Code/Number         Cell - Area Code/Number


Occupation _______________________________       (Required by Texas Ethics Commission)



Fax ________________________   Email_______________________________________


Is DDRWC your primary (voting) club? ____ 

Pct No. ____ Sen. Dist. ___ Cong. Dist. ___


*Annual membership dues for Associate Members (Republican men or members of other federated Republican women’s clubs) are $20.


Political advertising paid for by the Dallas Downtown Republican Women’s Club, 
Lisa Sutter, PAC Treasurer, PO Box 600503, Dallas, TX 75360
?Contributions are not federal tax deductible as charitable contributions. Corporate Contributions Are Not Permitted.