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Prince George Democratic Committee - Membership Form
2024-2025
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* Indicates required question
Name
Your answer
Home Address
Your answer
City, State, Zip Code
Your answer
Prince George Voting Precinct
Choose
Richard Bland
Templeton
Union Branch
Rives
Harrison
Bland
Blackwater
Brandon
Courts Bldg
Jefferson Park
I don't know
Home Phone
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Cell Phone
Your answer
Email
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I am a former member of the Prince George Democratic Committee
*
Yes
No
Description of Memberships
Applying for membership as: (see below)
*
At-Large Voting Member
Associate Member (Non-voting)
Please Further Designate:
Have you ever held any of the following positions?
Precinct Captain / Assistant Precinct Captain
Yes
No
Clear selection
Ex Officio Member Position
Yes
No
Clear selection
Executive Committee Member Position
Yes
No
Clear selection
Sub-Committee Interest
Choose
Social Media
VAN
Fundraising
Hospitality
Outreach
Legislative
Multiple
Other
Annual Dues are $15.00
annually per member, for At-Large and Associate Members
Signature
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Date
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