Participant Application Form

The mission of the Environmental Justice Caucus of the DPNM is to elevate the voices of all people regardless of race, color, gender, national origin, class, immigration status, disability, and sexuality so that environmental laws, regulations and policies respect all communities. The caucus aims to mitigate the disproportionate harm of climate change and pollution on disenfranchised communities through reducing emissions, securing clean air and water, protecting natural lands and wildlife, and opposing colonization. Actions undertaken by the caucus will include educating the public, initiating policies, promoting legislation, and supporting candidates in New Mexico that promote green values and the principles of environmental justice. We support and shall abide by the rules, goals, beliefs, and values of the DPNM, the Democratic Party of the United States, and the Democratic National Committee. Do you support this mission?

YES

Please check the details of your New Mexico Voter Registration at https://voterportal.servis.sos.state.nm.us/wheretovote.aspx

Are you registered as a member of the Democratic Party?

YesNo

Please enter your name and address below as listed in your New Mexico Voter Registration.

Name

First NameLast Name

Email address

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Does your phone number accept text messages?

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In which Congressional District do you reside?

CD 1CD2CD3

Who is your state senator (if you know)?

Who is your state representative (if you know)?

In which Democratic Ward and Precinct do you reside (if you know)?

How did you learn about the Environmental Justice Caucus?

To what other DPNM caucuses do you belong?

Who is your state representative, if you know

To what other environmental or political groups do you belong?