ESCAMBIA FEDERATED REPUBLICAN WOMEN'S CLUB MEMBERSHIP APPLICATION Please send the completed application with your check for $35 ($20 for Associates) to: Bettye Hodges 9950 Scenic Hwy. Pensacola, FL 32514-8136 NAME ______________________________ BIRTHDAY (month/day) _________________ SPOUSE_____________________________ EMPLOYER ___________________________ ADDRESS ___________________________ WORK# ______________________________ CITY/ZIP_____________________________ E-MAIL _______________________________ PHONE______________________________ FAX __________________________________ Please let us know how you would like to participate: Americanism _____Awards_____ By Laws_____Campaigns_____Chaplain/Sunshine_____ Community Relations _____ Historian/Press Book_____HospitalityPrograms_____ Legislation _____ Membership Outreach____Programs_____Public Relations_____ Special Scholarship_____ Telephone _____ Ways and Means _____Web Page _____