Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Which Membership Level are you interested in? *

Appointed Precinct Committeeperson - serve out the term of vacant elected Precinct Committeeperson until the next presidential election.

Appointed At-large Member - to represent a political issue, economic issue, or minority/underserved population to balance the DEC membership.

Associate Member - for those under the age of 18 who are pre-registered as Democrat or for those who can't meet attendance requirements of Precinct Committeepersons / At-large positions.

Not sure - I would like more information.