SCDC Membership Filing Form
This form will be used to file to be a member of the Surry County Democratic Committee
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Email *
First Name *
Last Name *
Voting Address *
The address where you are registered to vote.
City *
Zip *
Phone *
Please enter the number in the following format: 1234567890
Email *
Please confirm the email address you entered above.
Gender *
Please select one
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