2025 Luncheon Registration Form

Membership and Guest Luncheon - Registration Form

Last Registration Day - October 22, 2025
Your Name*

PrefixFirst NameLast Name
Email Address*
example@example.com
Contact Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation and Employer
Needed for PAC report - Ethics rule
Would you like to be updated about the upcoming events?

YesNo
Will you have a guest with you?

YesNo
Guest Name

PrefixFirst NameLast Name
Will you have another guest with you?

YesNo
Guest Name

PrefixFirst NameLast Name

Event Options

LunchPlated Lunch for one person

$40.00 Quantity
Item subtotal:$0.00

2026 MembershipMembership for the 2026 year (starts in January)

$35.00

2026 Associate MembershipAssociate Membership for the 2026 year (starts in January) - for men or women who have primary membership with another republican women's club

$20.00

Name TagSCRWC name tag

$15.00 Quantity
Item subtotal:$0.00

DonationDonation to the SCRWC to use according to their budget and club discretion.

$25.00 Quantity
Item subtotal:$0.00

Total

$0.00

Payment Methods

Credit Card

ACH Bank Transfer

NOTE: SCRWC cannot accept payment from corporate accounts. Please plan accordingly.

Tables seat 8. Table requests are not guaranteed, unless you buy a table. You may note them in the comment section.
If you have ever served as a former Board Member of SCRWC, please comment below your Name, Position and Years of Service.
Any additional comments:
Type table attendees here.
Should be Empty:

Membership and Guest Luncheon - Registration Form

Payment Methods