Mail this form with your $35* check, payable to Dallas Downtown Republican Women’s Club, to

Mary Silva, PAC Treasurer, 5806 Azalea Lane, Dallas, TX 75230-3402




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             Occupation _______________________________       
(Required by Texas Ethics Commission)



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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 $15. ___


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