DFL Senior Caucus New Member Request and Annual Membership Renewal Form
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Please enter current information in the blocks below this one for your information update, new-member request, or annual renewal.

Membership is individual--please submit a separate form per person.

If you can, please click the following link to make a voluntary donation to support the work of the Senior Caucus:

    https://secure.actblue.com/donate/dflsc.2021
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Last Name *
First Name *
Middle Name or Initial
Preferred Pronouns
Preferred Method for Official Notices *
Preferred e-mail address for communications (leave this blank if you have no e-mail accounts)
Cell Phone (optional ten digits like 222-333-4444)
Land-Line Phone (optional ten digits like 222-333-4444)
Street Address *
City *
Zip Code *
Senate District
Congressional District
Senior Caucus Chapters I Would Like to Attend (suggested locales) *
Required
Skills and activities you enjoy that you would like to share with the caucus. Examples include: writing, planning or hosting events, welcoming, technology, leadership, crafts of any type, cooking, volunteering, visitation, etc.
Issues that you would like to have addressed by the Sr. Caucus (for example, by presentations, resolutions, or endorsements)
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