Decatur County Convention Credential Form

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THIS FORM IS NOT TO BECOME A DELEGATE. If you wish to become a delegate to Chicago, use this LINK.

This credential form is for use to attend your county convention on Saturday, March 16, 2024. The county convention will pick Selectors who will vote on April 6, 2024 for TN Congressional District Delegates.

2024 County Convention Credential & Pledge of Support Form

All participants in the Saturday, March 16, 2024 County Conventions must complete this form.

LOCATION:

Decatur County Civic Center

190 Civic Lane, Parsons, TN 38363

REQUIREMENTS:
Tennessee Democrats wishing to participate in their 2024 County Convention must:

Be registered to vote in Tennessee by February 5, 2024*
Vote in the March 5, 2024 Democratic Presidential Preference Primary, Early Voting Feb 14-27*
Pledge to support the Democratic Presidential Candidate in the TN Presidential Primary.
Pledge to support the Democratic Party Presidential Candidate in the November 2024 General Election

(*Those born on or between March 6, 2006 and November 5, 2006 will be 18 by the general election Nov 5, 2024 and are exempt from the voter registration and primary voting requirements for delegate selection participation.)

Email *

US Congressional District- please look here if you are not sure which US Congressional District you live in. *

FIRST Name *

LAST Name *

Gender (by self-identification) *

Female

Male

Gender Non-Binary

DEMOCRATIC CREDENTIALS DECLARATION

I hereby certify that I am a registered voter in _________________________ County, TN and that I support the Democratic Party and will support the nominee of the Democratic Party in the 2024 Presidential election.

I requested a Democratic primary ballot in the 2024 Presidential Preference Primary* and did not participate in the primary of any other political party in the March 5, 2024 election.

PLEDGE OF DEMOCRATIC SUPPORT

I hereby pledge my support for __________________________________ for President of the United States and will participate in the my County Convention. If I am elected a County Selector, I will attend the April 6, 2024 Congressional District Convention.

*Those born on or between March 6, 2006 and November 5, 2006 will be 18 by the general election Nov 5, 2024 and are exempt from the voter registration and primary voting requirements for delegate selection participation.

Please indicate here if the following exemption applies to you: *Those born on or between March 6, 2006 and November 5, 2006 will be 18 by the general election Nov 5, 2024 and are exempt from the voter registration and primary voting requirements for delegate selection participation.

Yes

To affirm the above Democratic Credentials and Pledge of Support statements, select the COUNTY in which you are (or will be) registered to vote. *

To affirm the above Pledge of Support statement, enter the Democratic Presidential Candidate name. *

Primary Voting Requirement: If you are completing this form to pre-register and have not voted yet, please indicate your voting intention. You will confirm that you voted during convention check-in on Saturday, March 16.

I voted in the 2024 Democratic Presidential Primary.

Yes

I was not old enough to vote in the primary but will be 18 by November 5, 2024.

I declare I am a Democrat and I support the Democratic Party. *

Yes

I will support the 2024 presidential nominee of the Democratic Party. *

Yes

If I am elected a County Selector, I will attend the April 6, 2024 Congressional District Convention.

Yes

Street Address *

City *

State *

Zip Code *

Mobile Phone Number (if no mobile phone enter NA) *

Home Phone Number (if no home phone enter NA) *

Date of Birth

YYYY

Optional demographic info: Do you self-identify in any of the following ways? If so, check all that apply:

African American

Hispanic/ Latinx

Asian American/ Pacific Islander

Native American (tribal affiliation required, please see below)

Disability (including any person who might request disability accommodation or services)

LGBTQ+

Youth (under 36 at time of election)

Native American tribal affiliation, if applicable

Are you an Elected Official in TN? If so, please indicate the office you hold below and if it is partisan or municipal.

Thank you!

Please contact the TNDP if you have any questions:
maria@tndp.org
615-327-9779
Looking forward,
Maria Brewer, TNDP Director of Party Affairs

A copy of your responses will be emailed to the address you provided.

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