Membership Registration

Member Registration

Prospective members are required to submit the following information in order to fully register as a CCR member and be permitted to vote and run for CCR elected or appointed office. Chapter presidents must fill this out to be accredited as members of the Board of Directors. Please fill out the form below.

Member Registration

* Indicates required field

Name *

First

Last

Phone Number *

Personal Email *

School Email *

Address where you are registered to vote? If not registered yet, put your residential address. *

Line 1

Line 2

City

State

Zip Code

Country

Are you registered to vote? *

Affiliated Chapter? If you're starting a new chapter or its not pictured here, choose other. For new chapters, fill out our start a chapter form on the chapters page. *

Member Status *

Are you a current chapter president? *

Yes No

Graduation Year *

Resume *

Max file size: 20MB

Terms and Conditions: Your information will only be used for membership purposes and to verify you are a registered Republican or unaffiliated with the intent to register as a Republican. Your information may also be used, if you choose to provide your resume, with prospective conservative employers and campaigns seeking interns or staff. Your private information will be tightly guarded and used only for these verification and employment purposes. By filling out this form, you agree to these terms and conditions.

I agree to receiving marketing and promotional materials *

Submit

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