23RD LD Caucus - Delegate Candidate Registration Form
THIS FORM IS FOR 23rd LD RESIDENCES TO IDENTIFY THEMSELVES AS CANDIDATES TO BE DELGATES TO THE 2022 WASHINGTON STATE DEMOCRATIC CONVENTION.  TO BE A CANDIDATE, YOU MUST PUBLICLY IDENTIFY YOURSELF AS A DEMOCRAT, LIVE IN THE 23RD LEGISLATIVE DISTRICT, AND BE AT LEAST 18 YEARS OLD.  THIS CANDIDATE REGISTRATION FORM MUST BE SUBMITTED NO LATER THAN 10 a.m. ON MARCH 26, 2022.  HOWEVER, YOU ARE REQUESTED TO SUBMIT THIS COMPLETED FORM AS EARLY AS POSSIBLE.

PLEASE PROVIDE ALL REQUESTED INFORMATION AS COMPLETELY AS YOU CAN, AS THIS INFORMATION WILL BE REQUIRED TO ATTEND THE WASHINGTON STATE DEMOCRATIC CONVENTION ON JUNE 25, 2022.

PLEASE REACH OUT TO GINGER SOMMERHAUSER, ginger.sommerhauser@gmail.com OR 360 337-7334, IF YOU HAVE ANY QUESTIONS.

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Email *
Full Name *
Full Address *
Please provide the address you are registered to vote at, or that you reside at, if you are unregistered to vote.
Phone Number *
Gender Identity *
Delegate selection rules require that delegations be divided equally between male and female individuals. Those individuals who do not identify binarily as either Male or Female should select "Gender Non-Binary". These individuals do not count in the split between Males and Females. For instance, a Legislative District may have 5 males and 4 females, or 3 males, 4 females, and 2 gender non-binary individuals, as the difference between males and females is not more than 1, but may not have 2 males, 4 females, and 2 gender non-binary individuals, as the difference between males and females is 2.
Will you be attending the June Convention Virtually or In-Person? *
The Delegate selection rules passed by the WSDCC require Districts to notify the State Party how many of its delegates will be attending Convention virtually or in-person no later than April 1st. As a result, please let us know if you will be planning to attend virtually or in-person when you register so we can communicate this information promptly to the State Party upon your election.
If you would like to provide a statement (no longer than 500 words) for your election to delegate, please provide it here and it will be distributed to voting members no later than March 24, 2022.
Please identify which of the following categories you identify as for the purposes identifying our districts success with the delegate selection plan's Affirmative Action goals *
Each Legislative District was provided an Affirmative Action goal in the Delegate Selection Plan that represents the distribution of the communities that Legislative District represents. The information collected below is used to measure success with achieving this representation and will not be used for any purpose outside of the Delegate Selection process.
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A copy of your responses will be emailed to the address you provided.
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