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Register to Attend the 2012 Republican Convention Thank you for registering to attend the 2012 Idaho Republican Party State Convention June 21-23 at College of Southern Idaho in Twin Falls Please return this form with your check payable to the Idaho Republican Party, P.O. Box 2267, Boise, ID 83701. To use a credit card, please complete the form at the bottom. NAME(S): ___ EMAIL ADDRESS: ________ ADDRESS: CITY/STATE/ZIP: PHONE: OCCUPATION: EMPLOYER: County ___________________ District _____________ Arrival Date_________________ Committee Preference: Indicate your 1st, 2nd, and 3rd choice: Credentials____ Platform_____ Resolutions____ Rules____ (Note: Each delegation selects its own convention committee representatives). REGISTRATION AT THE DOOR IN TWIN FALLS WILL BE CALCULATE YOUR OWN COST: $100/PERSON. PLEASE REGISTER EARLY! ______ Tickets for Quota paid Counties x $50ea = $______ ______ Tickets for Non Quota paid Counties and Guests x $75ea = $_____ ______ Saturday Republican Women’s Breakfast x $25ea = $______ TOTAL – PLEASE REMIT THIS AMOUNT $___________ Name as it appears on card: Visa Master Card American Express Account Number: Amount to Charge: Expiration Date: Signature: Paid for the Idaho Republican Party. P.O. Box 2267, Boise, Idaho 83701. Not authorized by any candidate or candidate committee. Contributions to the Idaho Republican Party are not deductible as charitable contributions for federal income tax purposes. Contributions from foreign nationals are prohibited. Federal election law requires us to report your name, address, occupation and employer. www.idgop.org.
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