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Registration Form

Required Information

First and Last Name: To verify only registered Monroe County Republicans join. You can delete or change this once you log in.
House Number and Street Name: To verify only registered Monroe County Republicans join. You can delete or change this once you log in.
Day of the month you were born.: If your birthday is June 23,1967, you would enter 23. To verify only registered Monroe County Republicans join.

Additional Information

Verification

Please leave this box empty:
What County do we live in?:
What is two plus two? Write the word.: