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2022 DFL PRECINCT CAUCUSES - NON-ATTENDEE FORM

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A-3 www.d.org 651-293-1200 or 1-800-999-7457
(
Adopted 7 August 2021, Rev A)
2022 DFL PRECINCT CAUCUSES - NON-ATTENDEE FORM
If you want to participate in your local DFL precinct caucus, but can’t attend in person on Tuesday, Feb. 1, 2022, you can:
• Fill out this form and have someone else bring it on caucus night, or
• Send this form (or an email with all of this information) to the Chair of your local DFL Organizing Unit
no earlier than Monday, January 3, 2022 and no later than Saturday, January 29, 2022.
To nd out how to contact your local Chair, go to d.org/districtnder
As a non-attendee you won’t be able to vote (for candidates, delegates, or resolutions), but you will be able to:
• Be nominated and possibly elected as a precinct ofcer or a delegate or alternate to a higher level convention.
• Submit resolutions for caucus approval by attaching a Resolution Form. (Available at d.org/caucuses-conventions)
• Sign up to help in other ways: as an Election Judge, or as a member of a committee setting up for a higher level convention.
1. Tell us who you are and where you live. This information is required.
Name: ___________________________________________________________ Gender Identity: _______________________
Street: _________________________________________________________________________________________________
City: _________________________________________________________ State: MN Zip: _______________________
Precinct (and ward, if applicable): ____________________________________________________________________________
(Include this if you know it. If you don’t, please visit www.d.org/districtnder )
2. How can we get in touch with you? This information is optional, but useful if you get elected to anything.
Phone: ___________________________ E-mail:
______________________________________________________________
By giving us your e-mail address, you agree that we may use it to contact you.
3. Are you eligible to attend the caucus? This is required.
I certify that: 1. I live at the address indicated above, which is within the precinct or district.
2. I consider myself a member of the DFL Party and agree with its principles as stated in the Preamble of the
State DFL Constitution and Bylaws.
3. I am not an active member of any other party.
4. By November 8, 2022, I will be at least 18 years old and eligible to vote, as required to become a delegate or
alternate, or precinct ofcer; OR I will be at least 16 years old, as required to hold other party ofce.
4. Would you like to be nominated for anything? If hand-delivered, this form must be submitted at the caucus at least
15 minutes prior to the election for your nomination to be valid.
I would like to run for: Precinct Chair Precinct Vice Chair
I would like to Organizing Unit County Senate District City Ward
participate in my Delegate Delegate Delegate Delegate Delegate
local convention at Alternate Alternate Alternate Alternate Alternate
the following level: Pre-convention Pre-convention Pre-convention Pre-convention Pre-convention
committee * committee * committee * committee * committee *
Additional information about me for those voting:
_________________________________________________________________________________________________________
Continue on back of form, if necessary. * Indicate specic pre-convention committee(s) you are interested in (Nominations, Credentials, etc.) here.
5. Do you have a candidate and This section is optional. The information may be used if subcaucuses are necessary.
optional issue(s) preference? It does not count as a vote in the Preference Ballot. (You must be present to vote).
I am currently uncommitted to any candidate. I support _________________________________ for ________________.
I support the following issue(s): ___________________________________________________________________.
6. Sign your form before submitting it. This is required.
I afrm that the above is true and correct, and I recognize that it is my responsibility to determine whether or not I have been elected.
Signature: ______________________________________________________________________ Date: __________________
Please send me information about being an election judge.
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2022 DFL PRECINCT CAUCUSES - NON-ATTENDEE FORM

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Completed 2 February 2022

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