Request for Precinct Chair Appointment - Collin County Democrats

Precinct # *

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

Name on Voter Rolls: *

First

Middle

Last

As it appears on your voter registration card.

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: *

Email

Confirm Email

(Will be used for internal communication only and will not be published. Please do not use a work or school email address.)

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)]

Precinct Chair Applicants, Please Initial (2-3 characters, uppercase):

I agree that I will provide at least one method for constituents to contact me, to be published on the CCDP website. 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 can be up to two years, depending on the time left in the term, which expires in June of even-numbered years, and this is a statutory, unpaid position. *

I understand I need to attend (statutory and other) County Executive Committee Meetings as scheduled (at least quarterly, could be monthly) 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." *

Signature (name): *

Date: *