Each person joining the Committee must certify that he or she: a) is a Democrat; b) is a registered voter in James City County; c) believes in the principles of the Democratic Party and d) does not intend to support any candidate who is opposed to a Democratic nominee in the next ensuing election.
I the undersigned, having read the above, hereby state that I am a Democrat, that I am a registered voter in James City County, that I believe in the principles of the Democratic Party, and that I do not intend to support any candidate who is opposed to a Democratic nominee in the next ensuing election.
PLEASE PRINT
NAME_______________________________________________________________________________
ADDRESS ____________________________________________________________________________
CITY_________________________________________________________________________________
PHONE (H) ________________________ (O) ___________________________
EMAIL ADDRESS _____________________________________________
LEGISLATIVE DISTRICT______________________________________
COUNTY OR CITY JAMES CITY COUNTY
PRECINCT___________________________________________________
SIGNATURE________________________________DATE ________________________
Form 00-2006 JCCDC
Send completed form, with $20.00 check for dues, payable to “James City County Democratic Committee,” to JCC Democratic Committee, P.O. Box 2032, Williamsburg, VA 23187