Membership Application for the NW Democratic Club

Type of phone?(Required)
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Annual Club Memberships
T-Shirt Size(Required)

Volunteer Committees

Please check yes for all the committees you are interested in.
Community Engagement & Events
Identify organizations throughout our service area that need volunteers/support to show our commitment and involvement in the community. Secure and coordinate participation in various events throughout our service area as a host or participant.
Coordinate activities that will provide additional revenue to support candidates running for office.
Marketing & Communications
Create, distribute and share consistent messaging to the community that supports our mission to engage voters, register voters, and get out the vote through the website, email campaigns, social media platforms, and print media.
Membership & Hospitality
Recruit, engage, and retain members to support the club's mission. Attend events and serve as ambassadors at meetings and club-organized events.

Who should we contact in case of an emergency?


Do you have any health issues we should be made aware of?

Agreement & Signature

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By adding my name and the date, I affirm that I am now registered with the Volusia County Supervisor of Elections to vote as a member of the Democratic Party. I understand and agree that I have a continuing obligation to inform the NW Volusia Democratic Club immediately, should there be any change in my voter registration.
If you have any questions or require additional information, please email Membership Chair Donna Cochran at or text/call 407-323-6161.

Voter ID _______________ Precinct ________ Payment _________ Amount __________ Membership Card ____/____/____