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First Name(Required)

Last Name(Required)

Email(Required)

Phone

Ward

Address

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Date of Birth -include 4 digit year Required for background check

I have been a legal tax-paying resident of the District of Columbia since:

I have been a registered Republican in the District of Columbia since:

Please list previous volunteer experience:

Please list Republican candidates you financially supported:

Please list previous elected offices and/or conventions attended as a delegate or alternate delegate:

Please list Republican organizations you support or previously supported (DC Republican Committee, League of Republican Women, Log Cabin Republicans etc…)

I am interested in:

2024 Campaign volunteer

Get involved in my Ward grassroots

Coalition development

Volunteering at DC GOP office

Making phone calls

Please list specific skills and interests:

I am interested in 2024 candidate for local office:

Advisory Neighborhood Commission

DC State Board of Education

DC Council

Delegate to the U.S. House of Representatives

Shadow Representative or Senator

DC GOP Ward Chair, National Committeeman or National Committeewoman

2024 RNC Delegate or Alternate Delegate Pledge(fill in the name of your delegate of choice):

I pledge myself, if selected as a delegate or alternate delegate to the 2024 Republican National Convention, to vote for the nomination of _____________________________________________ as candidate for the Republican Party for President of the United States.

If your first choice is unsuccessful, please rank your preferred order of candidates from the alphabetical list below (Rank 1-7):

Ryan Binkley, Chris Christie, Ron DeSantis, Nikki Haley, Vivek Ramaswamy, David Stuckenberg, Donald J. Trump

Please attach your resume and/or include any additional supporting materials in one document.

Max. file size: 128 MB.

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Sign The Petition