Legal name as shown on your voter registration
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First Name
Middle Name
Last Name
My voter registration address is within the following county supervisorial district I am interested in representing on the Central Committee...
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District 1
District 2 (2 seats remaining)
District 3 (1 seat remaining)
District 4 (1 seat remaining)
District 5 (4 seats remaining)
Please provide an email address that you regularly check
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example@example.com
Optional: Please provide a phone number
Please enter a valid phone number.
Optional: Anything you would like the members of the Central Committee to know about you (biography, links, etc). If you already have a nominator, please provide their name below:
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