LD PCO Applicant Entry

Legislative District Application to Appoint a PCO

Please complete the following form to approve a member of your legislative district for the role of Appointed or Acting PCO.

Applicant's Full Name (As it appears on their voter registration)*

First Name Last Name

Applicant's Preferred Name

First

Applicant's Legislative District*

Applicant's Precinct*

Applicant's VAN ID*

2020 Dem Party Support Score*

2020 National Turnout Score*

Which PCO role is the applicant approved for?*

Is the applicant registered to vote?*

Address (As it appears on the applicant's voter registration)*

Street Address Address Line 2 City State ZIP Code

Is the applicant's address the same as their mailing address?*

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Applicant's Email*

Applicant's Phone*

Name of person completing this form*

First Name Last Name

Your LD Role*

Date*

Confirm you're a real person.*

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