HIGHLAND COUNTY DEMOCRATIC COMMITTE
 

Request to be nominated for membership

 

I, _____________________________________________________

             (Please print full name here)

request to be nominated for membership in the Highland County Democratic Committee. 

 

My address:      _______________________________________                               

                                  _______________________________________                              

                                  _______________________________________

                               

My phone number: ___________________________________

 

My e-mail address: _______________________________________________

 

With my signature below I confirm:

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I am registered to vote in Highland County, Virginia.  I acknowledge that the purpose of the Highland County Democratic Committee (Committee) is to conduct the affairs of the Democratic Party of Virginia in Highland County.  I believe in the principles of the Democratic Party and will do all within my power to aid in the victory of Democratic Party nominees in local, state and national elections as provided for in the Virginian Democratic Party Plan.  As a member of the Committee, I will encourage qualified residents of Highland County to register and vote and understand that the Committee shall adhere to and implement the policies contained in the platform and Party Plan of the Democratic Party of Virginia. 

 

 

Signature: __________________________________________   Date: _________________