California Democratic Party 2022 Endorsement Registration Form - Legislative Candidates - Page 1 of 2

Filing Deadline:

-Deadline for Candidates who will be participating in a Pre-Primary Endorsing Conference: Wednesday, October 2, 2019, 5 PM.

Candidates who file by this deadline will receive the Pre-Primary Endorsing Conference eligible voter list for the relevant district.

After this deadline, a candidate may file on-site at the appropriate Pre-Primary Endorsement Conference prior to the consideration of the relevant district at which the district is considered. On-site filing will require using a physical copy of the CDP 2019 Candidate Registration Form downloadable on the CDP Endorsements webpage: www.cadem.org/endorsements.

Instructions:

This form is for Legislative Candidates (U.S. House of Representatives, State Senate, and State Assembly) who wish to seek the California Democratic Party's endorsement consideration in 2019. The campaign public address, social media aliases, website, and campaign phone may be posted on the CDP website. All other information is for internal use only and will not be shared publicly.

For endorsement-related information, please visit the CDP Endorsements webpage. If there are any questions, please contact kasey@cadem.org or (916) 442-5707.

Office Sought *

U.S. House of Representatives

State Senate

State Assembly

District # *

Candidate First Name *

Candidate Last Name *

Elected Position/Present Occupation *

Committee Name *

Committee # *

Campaign Public Physical Address *

City *

County

Zip *

Other Counties in District

Candidate's Permanent Mailing Address *

City *

County

Zip *

Campaign Phone

Campaign Fax

Campaign Email *

Personal Phone - Mobile

Personal Phone - Day

Personal Email *

Website

Facebook

Twitter

Social Media - Other (Please Specify)

Staff Contact Information

	Name	Phone	Email
Campaign Manager	Name	Phone	Email
Consultant	Name	Phone	Email
Press Secretary	Name	Phone	Email
Key Contact #1	Name	Phone	Email
Key Contact #2	Name	Phone	Email

Treasurer (or Name of Person Filing Campaign Reports) *

Campaign Report Filing Address *

Treasurer Phone

Treasurer Email *

Email of the person who should receive the CDP Endorsement Registration Form submission confirmation. *

CDP DSCC List Terms of Use: The California Democratic Party (CDP) Democratic State Central Committee (DSCC) Member List is only to be used by the requester for communicating with DSCC Members regarding official CDP business, including but not limited to the CDP endorsement process, matters before CDP Standing Committees, and events taking place at CDP Conventions and Executive Board Meetings. The list may not be transferred, sold, duplicated, posted or published in any medium, in whole or in part. The list may not be used for commercial or any other purposes not authorized by the CDP. Unauthorized use of the list beyond permissible purposes is strictly prohibited. Failure to adhere to the terms will result in revocation of the requester’s right to use said list, loss of the requester’s right to request DSCC Member Lists for the remainder of the DSCC term, and, if applicable, prosecution or other legal action. The CDP DSCC Member List is as of the deadline prescribed by the CDP Bylaws and Rules. No changes may be made to the list past that deadline except as permitted by the CDP Bylaws, or as necessary to mitigate possible issues (e.g., voter registration discrepancy or changes, voter contact information update) or clerical error. For more information on the CDP endorsement process, please visit the CDP Endorsements webpage at www.cadem.org/endorsements. If you have any questions, please contact CDP Deputy Executive Director Kasey Walukones at kasey@cadem.org or (916) 442-5707.

By typing my initials in the box below, I affirm that I have read and agree to the DSCC list terms of use (above). *

By typing my initials in the box below, I affirm that I have been provided a link to the most current CDP Platform (www.cadem.org/platform). *

By typing my initials in the box below, I affirm that I have read the most current CDP Platform. *

By signing this form, I acknowledge that I am a registered Democrat seeking the endorsement of the California Democratic Party (CDP). I agree to abide by the CDP’s By-Laws and I will seek to resolve any and all problems in accordance with the CDP By-Laws. I am seeking this partisan office with the Democratic Party as my party preference. *

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Date (mm/dd/yy) *

Please upload a high-resolution portrait photo of the candidate.

Please upload a biography of the candidate.