If you would like to become a member of the JCRW, please print, complete, and return the membership form found below (along with your dues check):
*please note that men are welcome to join the JCRW as associate members.

$20 Annual Dues Include:

$12 toward the Jefferson County Republican Women
$5 toward the National Federation of Republican Women
$3 toward the Wisconsin Federation of Republican Women

NAME: ___________________________________ E-MAIL:____________________

ADDRESS:_____________________________________________________________

PHONE:_______________________________ CELL:__________________________

Please contact me before events _______ YES ______ NO

Is it okay to provide the above contact information to other members
of the JCRW?

_____ Yes _____ No

Please make your check payable to JCRW and mail to:Jefferson Co. Republican Women
PO Box 68
Helenville, WI 53137

If you need further information or have questions about the JCRW, contact Chairwoman Vicki Milbrath at 920-674-6637.

The JCRW welcomes you!