AAC-WCDP Membership Application
You must be a registered Democrat to apply for membership. Please provide all information to help us serve you and our party.
Email address *
Home Phone
Your answer
Work Phone
Your answer
Cell Phone
Your answer
Contact Information
The fields in this section that are marked with an asterisk are required by state law.
Name *
Your answer
Gender
Address *
Your answer
City, State and Zip *
Your answer
Occupation *
if retired, enter retired
Your answer
Employer *
if retired, enter former employer
Your answer
Payment Method
Membership Type
Payment Method
Make check payable to African American Caucus. Mail to AAC-WCDP, PO Box 25952, Raleigh, NC 27611
Membership Level
Additional Information
We ask for your precinct number and voting districts for our records. If you don't know your precinct and voting districts, please look up your voter registration record on the NC Board of Elections site here: https://vt.ncsbe.gov/RegLkup/
Precinct *
Your answer
NC House District *
Your answer
NC Senate District *
Your answer
US Congressional District *
Your answer
Are you an elected official, an officer of the Democratic Party, or an AAC officer? *
If yes, what position do you hold?
What are your areas of interest?
A copy of your responses will be emailed to the address you provided.
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