Member Information Annual Review
Every year, NBWDC is required to submit a verified Member Roster to the California and Orange County Democratic Party offices and to the Federal Elections Commission. Your cooperation in helping us keep the required accurate records is greatly appreciated.
First Name *
Name is it appears on Voter Registration Records
Your answer
Last Name *
Name is it appears on Voter Registration Records
Your answer
Email Address *
Your answer
Email Permission *
May we add you to our Email Newsletter list?
Political Party Affiliation *
Select the party affiliation that matches your Voter Registration record
The California Fair Political Practices Commission requires NBWDC to maintain the following information for all our dues-paying members.
Occupation *
Enter Occupation or "Retired"
Your answer
Employer/Business Name *
(If employed, enter Employer Name, If self-employed enter Business Name; if "Retired" enter NONE)
Your answer
Please provide your phone number(s)
Primary Phone #
Please include Area Code (eg: 111-111-1111)
Your answer
Primary Phone Type
Secondary Phone #
Please include Area Code (eg: 111-111-1111)
Your answer
Secondary Phone Type
Permission to Text
May we text you with event news and updates?
Current Street Address *
Street #, Street Name, Unit # if applicable
Your answer
Current Zip Code *
Your answer
Is the above address the same as your . . . *
Yes
No
Mailing Address
Voter Registration Address
If you answered NO in the above question, please include the other address(s) here:
Street #, Street Name, Unit #, Zip
Your answer
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