New Member Application

Join the East Orange Democratic Women's Club! Tell us a little about yourself and the topics, speakers, and activities you'd most like to see at future meetings.

Your Information

Please print carefully.

Full Name *

Date

Email *

Cell Telephone

Street Address

City

State

Zip

Home Telephone

Work Telephone

Voter Registration

Not sure of your status? Check your voter registration status here.

County of Residence

Voter Registration #

Precinct #

Topics you'd most like to hear about

Check all that apply.

State Legislative UpdatesFederal Policy and National IssuesVoting Rights and Election ProtectionWomen's Rights and Reproductive FreedomEducation PolicyHealthcare IssuesEnvironmental and Climate IssuesAffordable HousingHomelessness in our CommunityDiversity, Equity, and InclusionGun Violence PreventionCriminal Justice ReformLGBTQ+ RightsCivic Engagement and Grassroots OrganizingCampaign Strategies and Political ActivismPublic Speaking and Leadership DevelopmentCommunity Service OpportunitiesCandidate Forums and Meet-and-Greets

Other

1. What type of speakers would you like us to invite?

Check all that apply.

Elected OfficialsCandidate for Public OfficePolicy ExpertsCommunity LeadersAdvocacy OrganizationsEducatorsBusiness LeadersNonprofit OrganizationsPolitical Strategists

Other

2. Are there any specific issues or concerns affecting our community you'd like to address?

3. Would you be interested in participating in any of the following club activities?

Check all that apply.

Voter Registration DriveCommunity OutreachSign Waving EventsPost-Carding EventsTabling EventsFundraising ActivitiesLegislative AdvocacyMembership RecruitmentSocial EventsVolunteer OpportunitiesLeadership Roles

Other

4. Do you have a speaker or topic suggestion, or any additional comments?

Signature

Type your full name as your signature *

I certify that the information above is accurate, and I consent to being contacted about club membership and activities.

East Orange County Women's Democratic Club

Empowering Women, Engaging Communities, Defending Democracy.

Dwceocfl@gmail.com