Smithtown Democrats Application
We are your like-minded neighbors and we are energized for change! Join us to make a difference in Smithtown.
Email address *
Last Name *
Your answer
First Name *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Election District (you can look up here: https://voterlookup.elections.ny.gov/)
Your answer
Home Phone Number *
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Mobile Phone Number
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How would you prefer we contact you?
Are you a registered Democrat? *
How would you like to help? We will train you! (check all that apply) *
Required
Which local issues are important to you? (check all that apply.)
Availability (check all that apply)
Morning
Afternoon
Evening
Weekdays
Weekends
Comments/Questions
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By completing this application you are giving the Smithtown Democratic Committee permission to contact you with meeting and other notices. You may change your preferences at any time. Thank you for joining us!
A copy of your responses will be emailed to the address you provided.
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