Name of Applicant *

First Name

Last Name

Applicant Phone *

(###)

###

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Applicant Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Nominator *

To apply to be a DNC Committee Member, you must be nominated by two members of the state committee. Provide their contact information below.

First Name

Last Name

Nominator Phone *

(###)

###

####

Nominator Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Seconder *

First Name

Last Name

Seconder Phone *

(###)

###

####

Seconder Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which position are you applying for? *

Please note that these titles and categories are provided by the DNC. We recognize and honor our trans and nonbinary siblings, and are looking forward to revising this in the future.

Committeeman

Committeewoman