CANDIDATE DECLARATION FORM

The Shenandoah County Democratic Committee

Declaration of Candidacy for the Democratic Nomination

For Shenandoah County Office(s)

I, _                                          , declare myself a candidate for the Democratic nomination for the office of _______________________ in the general election on November 7^th, 2023.

In making this declaration, I certify that:

• I am a Democrat and not a member of any other political party, and I believe in the principals of the Democratic Party;
• I meet all requirements of state law to be placed on the ballot for the General Election;
• I am eligible to be the [position] under the laws of the Commonwealth;
• I do not intend to support, endorse, or assist any candidate who is opposed to the Democratic nominee in the next ensuing election;
• I will not participate in the nominating process of any other political party for the next ensuing election;
• I agree to abide by the Caucus Rules, the Virginia Democratic Party Plan, and all laws applicable to this nominating process and the next ensuing election.

PLEASE PRINT:

NAME________________________________________________________________________________

RESIDENCE ADDRESS____________________________________________________________________

CITY____________________________________________________________ ZIP__________________

MAILING ADDRESS (if different)___________________________________________________________

CITY____________________________________________________________ ZIP__________________

Phone  (H)  _____________________ (C)  _______________________  (W)  _______________________

E-mail  _______________________________________________________________________________

SIGNATURE______________________________________________________  DATE________________

This Declaration must be received by Brad Skipper ([email protected]) by email by May 31^st, 2023 by 5:00 PM.

For official use only:

Receipt date:        Time:        by:  _