Request for Precinct Chair Appointment - Collin County Democrats

Precinct # *

Must live in and be registered to vote in this voting precinct.

Do you currently live in the precinct and have an active voter registration? *

Name on Voter Rolls: *

First

Middle

Last

As it appears on your voter registration card.

Pronouns *

Date of Birth *

Preferred Name for Website: *

Voting Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address (if different):

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone:

Permission to text:

Yes
No

Home Phone:

Work Phone:

Please indicate which is your preferred phone: *

Cell
Home

Email (please use email associated with a Google account) *

Email

Confirm Email

* Will be used for internal communication only and will not be published. We use google accounts for access to our shared drives and chat, so we need a google account email to set up your access (does not need to be a gmail account, but any email associated with a google account)

Best Method to Contact Me *

Email
Text
Phone call
Other

Other Method to Contact

Occupation *

Required by Federal and State law for campaign finance reporting purposes.

Employer: *

Must not be a candidate for, nor holder of, an elective office of the federal, state, or county government. [Texas Election Code Sec. 161.005(a)(2)]

Please describe any current or prior roles you have held in Collin County Democratic Party (CCDP)

I agree that in order to fulfill my duties as a Precinct Chair that the CCDP may contact me via phone, text, and/or email.
I understand this commitment will expire in June of even-number years, and that this is a statutory, unpaid position.
I understand I need to attend County Executive Committee Meetings as scheduled and that I may be considered to have abandoned this office if I miss three consecutive meetings in a two-year term.
Oath of Affiliation: “I swear that I have not voted in a primary election or participated in a convention of another party during this voting year. I hereby affiliate myself with the Democratic Party."

I agree to and understand all of the above

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

Signature (name): *

Date: *