Last chance to be an platform convention add-on delegate

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Dear Democrats:

The deadline to apply to be an add-on delegate to the State Convention on Lowell on May 14 is almost here. Use this as an opportunity to contact people who might be interested in attending the convention. It is one more way to build your Democratic committee.

DNC Chair Howard Dean has been invited to speak at the State Convention, said Chair Phil Johnston during his remarks at the DSC meeting on Wednesday. As of now, Governor Dean has not yet accepted the invitation but we are optimistic. If the DNC Chair is able to attend, it should be an interesting convention. Registered Democrats who are youth (35 and under), minority or disabled are all eligible to apply.

ADD-ON DELEGATES
http://www.massdems.org/convention05/addonform.htm
Application deadline March 18 at 5 PM.
You are eligible to apply to be an add-on delegate if you are a registered Democtat and a youth (under 35), minority (Black, Hispanic, Asian American, Native American, Cape Verdean) or disabled. The application is available at the site listed above.

Fax completed applications to: [phone]

APPLICATION
ADD-ON DELEGATE APPLICATION FORM
2005 Democratic State Convention

This form must be filled out completely. NO exceptions will be made. Copies of this form will be accepted. To be filled out by add-on delegate applicant:

I am applying to be a (please check only one category and detail as appropriate):

❐ Youth Delegate. My date of birth is ________. (youth delegate applicants must be between 18 and 35 years of age. The number of youth delegates will be determined by Rule 30 in the Method of Selecting Delegates.)

❐ Minority Delegate. (in accordance with Article One of the Charter of the Massachusetts Democratic Party)
I am: Black Hispanic Asian American Native American Cape Verdean
Disabled Delegate. (In accordance with Article One of the Charter of the Massachusetts Democratic Party)

My disability is _______________ and I require the following special accommodations:______________

____________________________________________________________________________________________

Please print the following information. All information is mandatory. Please use voting address.
Name __________________________________________________________________Male Female

Address ________________________________________________________________

City ________________________________Zip ____________Ward/Precinct ________

Email ______________________________Phone ______________________________

State Senate District __________________________________________________________________
(if you do not know your ward, precinct or state senate district, please call your local elections commission or city or town hall for assistance.)

I attended/ran for delegate in my local caucus: yes no
I have previously attended a State Convention as a delegate: yes no
I participate in a Democratic organization: yes no (specify)_______________________________________________

I certify that I am a registered Democrat on or before December 31, 2004:

Sign: ____________________________________________________________________________

Date : ______________________

INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. THANK YOU.

Please return this form to the Democratic State Committee by 5:00 pm March 18, 2005. Late applications will not be accepted. If you have any questions, please contact 617-472-0637.

This application can be faxed to the Democratic State Committee 617 472-4391.

The Massachusetts Democratic Party
Philip W. Johnston, Chair
10 Granite Street,
Quincy, MA 02169
617-472-0637
www.massdems.org
Fax: [phone]