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150
F
ierce
I
mpactful
R
epublican
S
trong
T
railblazers
Black Men Of Texas
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STEP 1 OF 2
COMPLET APPLICATION BELOW:
Are you 18 years old or older?
Yes
No
Age Range
Choose an option
Have you servd in the military?
Yes
No
Check all that apply.
Choose an option
Are you a student?
Yes
No
What is your profession or line of work?
Do you possess any special skills or trades? If so, what is that skill or trade?
Are you registered to vote?
Yes
No
Are you a voting Republican?
Yes
No
I have voted in the following election (s):
2020 Republican Primary
2020 General Election
2018 Republican Primary
2018 General Election
2016 Republican Primary
2016 General Election
Copy of 2016 General Election
2014 General Election
None
During the past two years, I have ________ for a Republican candidate or for the Republican Party of Texas (check all that apply).
Block Walked
Phone Banked
Distributed Campaign Literature
Assisted with Mailings
Donated
Other
List other past Republican Party or campaign involvement if not listed above.
List all Republican political groups you are currently involved with and the role you occupy (if applicable).
PERSONAL STATEMENT. Please explain why desire to be a part of 150 F.I.R.S.T. Black Men of Texas.
Which category describes you? Please select all that apply:
Choose an option
For purposes of this affidavit: Adjudication and conviction refer to a conviction, plea of guilty or no contest (nolo contendre), probation, suspension, or deferred adjudication. Charge refers to a formal criminal charge as documented by a primary charging instrument (a complaint, information, or indictment) under the Texas Code of Criminal Procedure.
Have you been formally convicted of, plead guilty or no contest to a crime in the past ten (10) years of which you are currently on probation, parole, suspension, or deferred adjudication (outside of traffic / moving violation)?
Yes
No
I declare the following: Please provide all the relevant facts pertaining to any charge, adjudication, or conviction.
I attest that all aforementioned information is true and correctly to the best of my knowledge. (Initial Below)
Terms & Conditions. I will support adhere to and support the vision, mission, and purpose for this organization. I will uphold the U.S. Constitution. I will support the Republican Party of Texas Platform and Planks while avoiding any intentional conflicts to subvert them.
I agree to the terms & conditions
Join
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