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DPG Progressive Council Membership Application Form
A voting membership list based on this form will be used to determine who may vote on any matters brought before the DPG Progressive Council that Council.
Email *
Email *
First name *
Last name *
Pronouns
City (PO Box address) *
County? *
Congressional District? *
Cell phone number
Are you connected to any other progressive groups? If so, which ones?
Do you affirm the following: "I agree that, in matters involving my voting membership in and interaction with the Progressive Council, I will abide by the Bylaws of the Progressive Council.                                                                               I affirm belief in the goals of the Democratic Party of Georgia as stated in the Charter, I am not a member of any other political party or body as defined in the Georgia Election Code, and I am not affiliated with any political group whose ideals, goals, and methods are incompatible with those of the Democratic Party of Georgia as identified by the Executive Committee." *
Application date *
MM
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YYYY
A copy of your responses will be emailed to the address you provided.
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