Application for Nomination to Brevard Democrats 
I understand that, if elected, I would serve as the primary point of contact and lead organizer for Democrats in my voting precinct, and would be required to attend at least nine monthly BrevardDems meetings per year. Monthly meetings are held at the Viera Government Center on the fourth Wednesday evening of every month, and  any qualified Democrat may submit an application for nomination at https://brevarddems.org/join/ or at any DEC meeting. The Membership Committee shall (1) validate that a vacant seat is available in the applicant’s precinct; (2) validate the precinct and party of potential members; and (3) obtain a loyalty oath before placing nominations before the DEC for a vote. Qualified applicants whose applications are received before the 15th of any month will be nominated at the next regular or special meeting they attend, provided they submit a loyalty oath on or before the 5th of the same month. Qualified applicants whose applications are received after the 15th of any month or whose loyalty oaths are received after the 20th of any month may be nominated at the next regular or special DEC meeting they attend after the 1st of the following month, provided they are in attendance and have submitted a loyalty oath on or before the date of the meeting.  If an applicant does not attend a regular DEC meeting within three months of the date of their application, the application will expire and must be resubmitted. 
Sign in to Google to save your progress. Learn more
First Name on Voter Registration Card *
If you do not have your voter registration card, you can look up this information at bit.ly/findavoter.
Last Name on Voter Registration Card *
Preferred Name
Street Address *
City *
Zip Code *
Cell Phone *
Other Phone
Email. (By submitting my email address I am acknowledging receipt of occasional emails from BrevardDems. BrevardDems keeps all emails confidential and in house) *
Facebook Profile Name (optional) 
We have a secret Facebook group for all of our elected members to stay abreast of happenings in the county.  You will be sent an invitation upon your election to the DEC
Date of Birth *
MM
/
DD
/
YYYY
Precinct (if known)
Are you interested in joining one of our Committees?  These committees in particular are seeking new members:  Campaign & Candidates, Affirmative Action Fundraising, Voter Registration and Young Democrats. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.