2018 - 2019 FCRC Membership * Email Address (do this first then hit tab to auto-fill form) select N/AMr.Mrs.Ms.Capt.Cmdr.Col.Dr.Fr.Hon.Lt. Col.LTCMGMaj.PastorProfessorGen. * Title/Prefix * First Name * Last Name select N/AJr.Sr.IIIM.D.D.O.Esq.J.D.Ret.Ph.D. Suffix * Mailing Address * City select *RequiredAKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVTWAWIWVWY * State * Zip Code select -- Select A District --*N/ABraddockDranesvilleHunter MillLeeMasonMount VernonOut of DistrictProvidenceSpringfieldSullyUnknown My Voting District (Optional) select -- Select A Precinct -- My Voting Precinct (Optional) * Please provide at least one phone number. Cell Phone Home Phone Work Phone Work Extension I Am Retired * Employer * Occupation * Location of Employer * Check The Funding Source That Applies To You: FEDERALLY PERMISSIBLE: This contribution is made with my own personal funds and not with the funds of a corporation, union, national bank, non-federal political committee or other funds not permissible under federal law.NOT-FEDERALLY PERMISSIBLE: This contribution is made with corporate, union, national bank, non-federal political committee funds or other funds not permissible under federal law but are permissible under state law. Please correct the following to continue: × Check here to confirm the following statements are true. By my signature, I pledge to support all Republican nominees in all elections through completion of this membership period, and agree to the below terms. I further understand that it will be my responsibility to attend scheduled County Committee meetings called by the Chairman of the Fairfax County Republican Committee. Should I miss three consecutive meetings, I understand that I will become a non-voting member of the FCRC. My duties as a member of the County committee include actively working in my precinct, identifying Republican voters, and encouraging them to get out the vote. (Article II, Subsection E(2) of the County Party Plan of Organization.) Submit Contributions are not deductible for federal income tax purposes. Federal and State laws require us to use our best efforts to collect and report the name, address, occupation, employer and location of employer of all contributors. Contributions received through this website will be deposited into our Federal Account and are subject to federal requirements and limits unless you have checked the NOT-FEDERALLY PERMISSIBLE box above on this form. If you wish to make a corporate or other contribution that is not permissible under federal law but is permissible under Virginia law, please check the NOT-FEDERALLY PERMISSIBLE box above. Please contact FCRC at 703-766-4467 with questions.