At-Large Delegate Application

Application Deadline: March 21st

 

First Name
Last Name
Address
City
Zip Code
Home Phone
Work Phone
Cell Phone
Fax Number
Email
Elected Title (if applicable)
Occupation
Date of Birth
Candidate of Choice
I hereby notify the Chair of the Democratic Party of New Jersey that I wish to be a candidate for delegate to the 2008 Democratic National Convention, and I pledge to support:
Clinton Obama
Gender
Male Female
Please Select All That Apply:
African American Arab American Asian American
Caucasian Hispanic Native American
Disabled LGBTI Senior
Youth Labor Other
Yes, I want to be a neighborhood leader and commit to talking to 25 of my neighbors between now and election day. Click Here for More Info

Once your application is processed, you will receive confirmation from the NJDSC.

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