Convention Delegate Pre-Filing Form If you would prefer to print, fill out, and mail the pre-filing form, click the button marked “Download PDF” to download a printable copy. Please note that all forms must be received no later than Wednesday, February 21st, 2024 by 5PM.Download PDF Name(Required) First Name (Required) Middle Name Last Name (Required) Last 4 SSN (Helpful) Address(Required) Street Address City ZIP Code Email Address(Required) Primary Phone(Required)Secondary PhonePrecinct Magisterial DistrictSelect your districtBrentsvilleColesGainesvilleNeabscoOccoquanPotomacWoodbridgeCongressional DistrictSelect your district7th Congressional District10th Congressional DistrictOccupation*(Required) (or “retired”)Employer*(Required) (can be “self”)City, State of Employment*(Required) *State and federal regulations require collection of this information.I hereby apply for (please check those that apply and fill in the “Amount Paid” field for each):PWCRC Convention Delegate Prince William County Republican Convention When: March 2, 2024 Where: Osbourn Park High School (8909 Euclid Ave., Manassas, VA 20111) Purpose: To elect county Chairman, new committee members, and delegates to the 7th CD, 10th CD and RPV conventions. Call can be found on website: https://pwcgop.gop/2024-pwcrc-convention-callAmount Paid Mandatory Fee: $20PWCRC Membership Membership Prince William County Republican Committee: 2024- 2026 Biennial membershipCounty Convention attendance is not required to be elected.Payment of dues with this application is recommended, but payment may be made at the beginning of the next regular business meeting.Amount Paid Membership Dues: $1007th District Convention Delegate 7th Congressional District Convention When: March 23, 2024 Where: Riverbend High School (12301 Spotswood Furnace Rd., Fredericksburg, VA 22407) Call can be found on website: https://virginia7.gop/convention-call. County Convention attendance is not required to be elected.Amount Paid Voluntary Fee: $510th District Convention Delegate 10th Congressional District Convention When: April 27, 2024 Where: John Champe High School (41535 Sacred Mountain St., Aldie, VA 20105) Call can be found on website: https://vagop10.org/2024-convention-of-the-10th-congressional-district-republican-committee. County Convention attendance is not required to be elected.Amount Paid Mandatory Fee: $25RPV Convention Delegate Republican Party of Virginia 2024 Quadrennial Convention When: May 31 & June 1, 2024 Where: Hampton Roads Convention Center (1610 Coliseum Dr., Hampton, VA 23666) Call can be found on website: https://virginia.gop/event/2024-quadrennial-convention. County Convention attendance is not required to be elected.Amount Paid Mandatory Fee: $45Donation Additional Contribution Support the Prince William County Republican CommitteeAmount Paid Amounts paid are non-refundable. Fees are used to cover convention expenses. All delegates must meet the Qualifications for Participation found in the Official Call. Each applicant must complete a separate application per person. Photo ID Required at all ConventionsTotal Credit Card(Required) I hereby pledge my intent to support all nominees of the Republican Party for public office in the ensuing election.Signature(Required)Date(Required) Month Day Year
