Clark County Dems Central Committee Nomination Form
PLEASE READ BEFORE PROCEEDING! 

Please use this form to submit a nomination to be added to the Clark County Central Committee. Please fill out the form as completely as possible. Your information will be used to confirm you are a registered Democrat. 

Please note, your nomination will be processed in the order it is received. To be successfully added you must be 1) A registered Democrat in Clark County, 2) Approved by the County Central Committee at the next regular meeting after nomination. Meeting dates can normally be found on our website - clarkdems.com.

Joining the County Central Committee as a member is a responsibility that requires you to be engaged in organizing your community and to attend at least 2 meetings during each year of your term. You do not have to join the County Central Committee in order to be involved with the party. Please only nominate yourself if you are willing to be engaged at a high level. 
Sign in to Google to save your progress. Learn more
Email  *
First Name *
Last Name *
Cell Phone Number *
Birthdate *
MM
/
DD
/
YYYY
Address where you are registered to vote *
Zip Code where you are registered to Vote
Commission District: Commission District: Use this link to locate your Commission District if needed. *
Precinct 
I understand that being a Clark County Central Committee Member requires that I attend at least 2 meetings / year in each year of my term *
Required
I understand that my nomination must be vetted, processed and voted on at the next regular meeting of the Clark County Central Committee. My nomination is not automatically approved. *
Required
I understand that this nomination is for the COUNTY Central Committee ONLY. This nomination does not apply for the STATE Central Committee. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Clark County Democratic Party.

Does this form look suspicious? Report

Google Forms