RegV0T3/[523] - The Republic Story

Welcome to the Registration Page

The below form works 2 fold, the main one is to help Clean up our Voter Rolls, however, there are some general questions to be answered if you so choose. Those questions are for reaching out to you and see if you’d like to be involved. Those questions are NOT required to submit the information. Thanks for your time in this matter.

Registration

First Name

Last Name

Physical & Mailing Address

Physical Address

City

State

Zip Code

If Mail is Different from Physical

Please answer below questions… How’d you hear about us?

Would you like to be involved in the Republic?

If a Republic form of government was in place, do you think it would work?

Are you willing to recommend the item that brought you here?

If Yes to above recommend question, what was it?

Would You Like To Take a Survey… However It’s NOT Necessary