RCDC Nomination for Committee Membership
Online Submission Form (Also available as printable RCDC Nomination for Committee Membership form. )
Email address *
Before proceeding, please verify by checking YES that the nominee agrees to the requirement to sign the following pledge: "I, (name), a registered voter in the City of Roanoke, VA, declare myself to be a candidate for membership on the Roanoke City Democratic Committee. I also declare that I believe in the principles of the Democratic Party and that I will not support any candidate opposed to any Democratic nominee as long as I am a member of the Committee." *
Required
Full Name of Current RCDC Member submitting this nomination. *
First Name of Nominee (as appears on Voter Registration) *
Last Name of Nominee (as appears on Voter Registration) *
Address (as appears on Voter Registration) *
Cell Phone of Nominee *
Email Address of Nominee (non-government email, please) *
Membership Membership Type: An asterisk (*) denotes NON-VOTING membership. *
A copy of your responses will be emailed to the address you provided.
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