Become a member of the Republican Party of Puerto Rico

I support the entry of Puerto Rico as a state of the Union and believe in the principles of the National Republican Party including the defense of the nation, defense of the institution of the family, and upholding of traditional values.

Last Name:
First Name:

(As they appear on your electoral registration ID)

Postal Address:
Municipality:
Ocupation/Profession:
Electoral ID:
Age:

Contact Information

Personal

E-mail
Home Tel:
Home Fax:
Celular:

Professional

E-mail
Tel. :
Fax :
Celular:

Do you have friends or family members in the continental United States could be interested in joining the National Republican Party?

Name: City/State:

E-mail: Tel: Fax:

I wish to be recognized with an ID Card identifies me as a contributing member of the Republican Party of Puerto Rico by making a contribution of:

(make out check to Partido Republicano de Puerto Rico)