Special Registration by Reason of Citizenship Status

Special Registration by Reason of Citizenship Status

If you would like to file as an Assembly District Election Meeting (ADEM) candidate but you are unable to register to vote due to your citizen status, you must complete the following registration form.

On the form below, provided by the Chair of This Committee, potential candidates will:

attest that if eligible to register to vote you would do so and do so as Party Preference Democratic; and
attest that you reside at an address within the Assembly District of your candidacy and provide that address; and
have obtained the name, voter registration address, and signature of a registered Democrat in the state of California, which person will be serving as a reference for the person submitting the form; and
agreed in writing to abide by the Code of Conduct.

Candidate Information

First Name *

Last Name *

Address *

City *

ZIP *

Phone # *

Date of Birth *

Email Address *

County *

Assembly District (If you do not know your Assembly District, you can find it HERE *

Check the 'YES' button if you would like to be eligible for the Executive Board. (Candidates that are eligible for the E-Board will have an asterisk following their name) *

YES

NO

Gender *

Self-Identified Female

Other than Self-Identified

I attest that if eligible to register to vote, I would do so and do so as Party Preference Democratic *

Yes

I attest that I reside at an address within the Assembly District of my candidacy *

Yes

I agree to abide by the CDP's Code of Conduct *

Yes

Registered Democratic Reference Information

Reference First Name *

Reference Last Name *

Registration Address *

City *

ZIP *

Phone # *

Date of Birth *

Email *

County *

Assembly District *