York-Poquoson Democratic Committee
Membership Application
I certify that I am a Democrat, registered to vote in (check below) York County or the City of Poquoson, Virginia, and subscribe to the principles of the Democratic Party. It shall be the duty of every local Committee, as well as each officer and member thereof, to seek the registration of Voters, to perfect the Democratic committee within the county or city, and to do all within their power to aid in the victory of the Democratic nominees in all elections. *
Date *
First Name *
Middle Name (or initial)
Last Name *
Street Address *
City *
State *
Zip Code *
Cell Phone (enter with spaces, e.g. 757 888 9999)
Home Phone (enter with spaces, e.g. 757 111 2222)
EMail *
MEMBERSHIP DUES are annual and deemed as voluntary contributions. Membership dues are vital to York-Poquoson Democrats for they are our principal means of financial support, and our continual efforts will be strengthened with your active involvement and funding support. Membership dues are not tax deductible. *
Dues / Contribution *
Polling Place (Poquoson)
Polling Place (York County)
Congressional District. Check at https://whosmy.virginiageneralassembly.gov
VA Senate District. Check at https://whosmy.virginiageneralassembly.gov
VA House District. Check at https://whosmy.virginiageneralassembly.gov
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Help us engage you by identifying your interests from the list below. (Check all that apply)
What networks do you belong to which may share our mission and/or resources? (For example-civic, union, trade organizations, other special interest memberships)
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