Join the Brooklyn Democratic Party County Committee and represent your community, your neighborhood and your block.
Signers of this form authorize any necessary steps to effectuate candidacy, including printing of designating petitions and retention of representation in case of challenges. If unopposed, person will be elected uncontested; if opposed, person's name will appear on the Primary Election ballot in one Election District.
Sign in to Google to save your progress. Learn more
First Name (of candidate) *
Last Name (of candidate) *
Suffix (exp. Sr., Jr., etc?)
Email *
Phone Number (of candidate) *
Date of Birth (of candidate) *
What's Your Political Party (of candidate) *
Street Address (of candidate) *
Apartment Number (of candidate) *
Borough *
Zip Code *
What is your Assembly District?
First Name (of referrer) *
Last Name (of referrer) *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.