Ohio Federation of Republican Women
Club Membership Reporting Form

If you have more than 30 members, please submit extra forms.

Please list members alphabetically by last name

Total due per member is $15. (This is $5.00 for OFRW and $10 for NFRW). 
Additionally, there is a once a year $15 club service fee due to NFRW before March 1 (Make checks payable to OFRW).

Please be sure to include each member’s email address
so they will receive updates from OFRW and NFRW.

If you have any comments or questions, please call the OFRW Office at (614) 456-2054 or email: [email protected]

Dues and service fee may be sent via US Postal service to: 
Mary Beth Kemmer, OFRW Treasurer, 615 Sedgwick Way, Troy OH 45373-5421
   
Payment may be sent via US  Postal service to:
 Mary Beth Kemmer, Treasurer OFRW
 615 Sedgwick Way, Troy, Ohio  45373-5421

Or, you may submit your payment via Pay Pal:
   

Please list members
 in alphabetical order
according to last name.

Please, use your "tab" key to move to the next  input box
    
After you have completed the form, please take a second to make sure you have not made any typographical errors, and that each box contains an answer. Then,  please scroll down to the bottom and  click on "send it".  If you have any comments or questions, please call the OFRW Office at (614) 456-2054.

Using your "tab" key will move your cursor to the next box.


THANK YOU!




Date:
Payment Method (Check or Pay Pal?):
County:
Club Name:
President's Name:
President's Phone (with area code):
President's email:
Name of Person Submitting Form:
Submitting Person's Position:
Submitting Person's Address:
Submitting Person's City and Zip Code:
Submitting Person's Phone Number
 (with area code):

Submitting Person's Email address:
Enter Club Members Below:
1) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
2) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
3) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
4) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
5) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
6) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
7) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
8) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
9) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
10) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
11) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
12) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
13) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
14) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
15) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
16) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
17) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
18) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
19) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
20) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
21) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
22) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
23) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
24) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
25) New Member? (Enter 'Yes' or 'No'):
Member's Last Name:
Member's First Name
 (with middle name if given):
Member's Address:
Member's City, State and Zip Code:
Member's Phone Number
(with area code):
Member's Email Address:
If you have more members to report, please submit this completed form
 and then start a new form for the next 30 members.
Please make sure that AFTER you click "send it" below, that a screen pops up showing you:
"Form Submission Results"
If you do not see a page like that, then your report has NOT been submitted.
Please confirm that you have entered information correctly and click "send it" again,
until you see the form submission results page on your browser.
It would be wise for you to print a copy of the "Form Submission Results" for your records.
Thank you!
                   Click here  
Copyrightę OFRW | All Rights Reserved | Paid for by Ohio Federation of Republican Women
Treasurer Mary Beth Kemmer, 211 South Fifth Street, Columbus, OH 43215
Not authorized or endorsed by any candidate or candidate's committee
Web Design by Lyn Bliss

Payment and forms may be submitted via US  Postal service to:
 Mary Beth Kemmer, Treasurer OFRW
 615 Sedgwick Way, Troy, Ohio  45373-5421