The Democratic Party of Georgia African-American Caucus Membership Sign-Up
All Democrats within the state of Georgia are eligible for becoming members of the DPG African American caucus. By completing and submitting this form, you are acknowledging the following:

* You identify as a Democrat;
*  You reside within the state of Georgia
*  You agree to support the efforts of this caucus to organize for and support African-Americans running for office

First Name *
Last Name *
Phone Number
Address
County *
Zip Code *
Do you have a position with the African-American Caucus? If so, please note it:
Congressional District in which you reside
Are you currently a member of the The Democratic Party of Georgia African-American Caucus ? *
What issues do you think are most important to African-American Georgians (select up to 3) *
Required
Are you willing to help Georgia Democrats win? If so, please tell us how!
Which Committee are you interested in serving on?
Are you interested in running for office?
Clear selection
Is there any other information you feel important to share with The Democratic Party of Georgia African-American Caucus ?
By submitting this you are affirming that you are a Democrat and not a member of any organization in direct support of any other political party *
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