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.)

Alternate Email

Alternate Cell Phone

Format: (000) 000-0000.

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?

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

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)

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)

Would you like to request a financial hardship waiver for your alternate dues?

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.