York-Poquoson Democratic Committee

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Membership Application

I certify that I am a Democrat, registered to vote in (check below) York County or the City of Poquoson, Virginia, and subscribe to the principles of the Democratic Party. It shall be the duty of every local Committee, as well as each officer and member thereof, to seek the registration of Voters, to perfect the Democratic committee within the county or city, and to do all within their power to aid in the victory of the Democratic nominees in all elections. *

York County

City of Poquoson

Other:

Date *

YYYY

First Name *

Middle Name (or initial)

Last Name *

Street Address *

City *

Yorktown

Poquoson

Other:

Required

State *

Virginia

Other:

Required

Zip Code *

Cell Phone (enter with spaces, e.g. 757 888 9999)

Home Phone (enter with spaces, e.g. 757 111 2222)

EMail *

MEMBERSHIP DUES are annual and deemed as voluntary contributions. Membership dues are vital to York-Poquoson Democrats for they are our principal means of financial support, and our continual efforts will be strengthened with your active involvement and funding support. Membership dues are not tax deductible. *

Individual ($30)

Family ($45)

Student ($15)

new

renewal

Required

Dues / Contribution *

Credit, use the "Dues / Donations" button on https://www.yorkpoqdems.org

Check, payable to YPDC, mail to YPDC, P.O. Box 1121, Yorktown, VA 23692-1121

Required

Polling Place (Poquoson)

Polling Place (York County)

Congressional District. Check at https://whosmy.virginiageneralassembly.gov

VA Senate District. Check at https://whosmy.virginiageneralassembly.gov

VA House District. Check at https://whosmy.virginiageneralassembly.gov

Do you use the following media? (Check all that apply)

Twitter

Facebook

Instagram

Help us engage you by identifying your interests from the list below. (Check all that apply)

Canvas, make phone calls, display yard signs, drop literature in your neighborhood

Volunteer at the polls

Host a meet-and-greet

Event participation, planning, etc. (July Parade, August Picnic, Poquoson Seafood Fest)

Fundraising (solicit donors, host or help with an event)

Voter Registration and Get Out The Vote (GOTV)

Technology (website design / database management, etc.)

Communications (newsletter, news articles, letters to the editors, fact sheets)

Diversity Outreach (youth, minority, LGBT, limited resource populations, ESL, etc.)

Precinct Building (developing volunteers and leaders in your precinct)

Running for office and/or identifying and recruiting potential candidates

Using social media to share campaign and election posts

Other:

What networks do you belong to which may share our mission and/or resources? (For example-civic, union, trade organizations, other special interest memberships)

Special skills, abilities and knowledge:

Issues interests:

How did you hear about York-Poquoson Dems? *

Neighbor, word of mouth

Table at the election polls

Poquoson Sea Food Festival

Post Card

York-Poquoson web site

Other:

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