2012 NDGOP Convention Registration
2012 NDGOP Convention Registration
2012 NDGOP Convention Registration
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First Name
State
Zip Code
Registration Data: I certify that I am a (please choose all that apply) Delegate Legislator Alternate Candidate District Chair Staff Guest
Registration Fees: Please choose one of the following ****Must be postmarked by Monday, March 26 No Exceptions***" Delegate ($80) Alternate ($60) 30 yrs and under ($40)
Convention Events: Indicate number of tickets/total for each event Saturday, March 31 Saturday Night Rock - $15/person (Paid Members of the NDGOP Admitted Free) Sunday, April 1 First Lady's Prayer Breakfast - $15/person Total Registration Fees (from above) and Events Amount Enclosed
Please make check payable to ND Republican State Convention, or complete credit information:
Governor's Club Dinner will be held on Friday, March 30. Contact Marsha Reimnitz at 701-250-7001 for more information. Visa Credit Card # Name on card: Mastercard Discover
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FORM MUST BE APPROVED BY THE DISTRICT CHAIR BEFORE IT WILL BE PROCESSED (see the back of this form for process and information) SEND ALL FORMS TO: NDGOP, PO BOX 1917, BISMARCK, ND 58502
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To become a delegate for the convention, please complete the entire application.
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The completed form must be approved by the District Chair before it will be processed through registration (postmarked by Monday, March 26 no exceptions)
* To verify District Chair information, please check the party website (http://www.northdakotaqop.orq/about/district-chairs/) or call headquarters and ask for Dee (701-255-0030).
Information:
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State party dues are renewed on an annual basis, beginning the first of the year. In order to get free admission to the Saturday Night Rock, please renew your dues. You can renew your dues via the party website (www.ndgop.org ).
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The Governor's Club Dinner will be held on Friday, March 30. If you would like to attend, please contact Marsha Reimnitz at 701-250-7001 or marsha@dalrympleforgovernor.com Governor's Club dues are renewed based on when you originally joined (anniversary date). Please note that the Governor's Club Dinner registration is separate from convention registration.