2025 Congressional District 6 Convention

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

NC-6's Congressional District Convention will begin at 12:00pm on May 10th. You can attend the convention virtual on Zoom and in-person at 555-D West Center Street EXT d, Lexington, NC 27295.

Please complete this section using your personal information! You are not allowed to designated a proxy for Congressional District Convention.

Please reach out to Sabrina Berry at sabrinacberry@gmail.com if you have any questions.

Email *

Prefix (Optional)

Dr.

Ms.

Mrs.

Mr.

Other:

Clear selection

First Name *

Please provide your first name EXACTLY as it appears on your voter registration and do not include any prefixes or titles.

Middle Name

Last Name *

Please provide your last name EXACTLY as it appears on your voter registration and do not include any suffixes.

Suffix (Optional)

Sr.

Jr.

III

Other:

Clear selection

Pronouns (Optional)

Phone Number *

If you are planning to dial-in to the meeting, you MUST dial-in from this number.

Street Address *

This MUST match the address on your voter registration

Street Address Line 2

ex: Apt #

City *

Zipcode *

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

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of North Carolina Democratic Party.

Does this form look suspicious? Report

Forms