Click here to download a Proxy Form.


 Complete the form, bring it to the meeting and present it to the secretary prior to the meeting.






KNOW ALL MEN BY THESE PRESENTS, that I, ______________________________________________ of ____________________________________________________, do hereby constitute and appoint _________________________________________ my true and lawful attorney, to vote as my proxy at a meeting of the Republican (State, District or County) Executive Committee on the _______ day of ___________________________, 20_____, or at any adjourned meeting thereof and for me and in my name, place and stead to vote upon any question that may properly come before such meeting, with all the power I should possess if  personally present, hereby revoking all previous proxies.


IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal, this ____ day of ________________, 20____.


_________________________________ (Seal)



__________________________________ (Seal)



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