VCDCC Alternate Form

VCDCC ALTERNATE FORM 2025 (Rev. 1/2025)

This form is to be completed by the alternates appointed by Elected, Ex-Officio, and Associate delegate members of the Ventura County Democratic Central Committee. Have questions? Please email VCDCC.Secretary@Gmail.com.
Alternate Full Name*
Alternate Signature (By signing here you agree to all VCDCC Bylaws and Standing Rules, CDP Code of Conduct and VCDCC & CDP rules.)*

Clear
Alternate Email*
Alternate Cell Phone*
Alternate Address*

Street Address

Street Address Line 2

CityState

Zip Code
Member Full Name*
Member Email*
This will allow the member to know when you've filled out the form!
What gender identity do you currently identify with?*
Cisgender means you identify with your assigned gender at birth. Transgender means you identify with a different gender than your assigned gender at birth.
Do you identify as a member of the LGBTQ+ Community?*

YesNoPrefer Not to Share
If you would like clarification, please visit these resources

https://www.transhub.org.au/101/cis

https://gaycenter.org/about/lgbtq/
Please identify your race and ethnicity*

Black / African AmericanAsian / Pacific IslanderIndigenous American / IndianChicano/ChicanaLatinx/a/oWhiteNot Listed
Alternate Congressional District*
As of the 2023 district lines
Alternate State Senate District*
As of the 2023 district lines
Alternate State Assembly District*
As of the 2023 district lines
Alternate Supervisory District*
As of the 2023 district lines
Occupation
Employer
Committee Assignment (Optional)

FundraisingField Operations (voter outreach)CommunicationsCandidate Recruitment & TrainingBudgetBylawsResolutionsSocial Events
Member Type and Dues Amount https://secure.actblue.com/donate/membershipfees (If you are an alternate please verify if the $5 have been made by your member)*

Alternate- $5Club Alternate - No Cost
Would you like to request a financial hardship waiver for your alternate dues?

YesNo
This form and payment shall be received a minimum of 30 minutes prior (5:55PM) to the first order of business (6:25PM) in a meeting in order to be eligible for processing your Alternate.
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